First Author: D.Richards UK
Co Author(s): K. Gopalakrishnan K. Madhusudhana H. Cook L. Downey S. Arora
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To assess the outcomes of half-dose photodynamic therapy for treating patients with chronic central serous chorioretinopathy and validate its use in the UK’s National Health Service.
An interventional retrospective case series in a large National Health Service ophthalmology department over a 5 year period.
31 eyes from 31 patients with chronic central serous chorioretinopathy (defined as a minimum of 6 months disease duration) were treated with half-dose verteporfin combined with standard fluence photodynamic therapy. Main outcome measures were improvement in best corrected visual acuity in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters, change in central foveal thickness on optical coherence tomography, number of treatment sessions undertaken and major complications by the final appointment visit. Results were compared to published data.
The mean age of the patient cohort was 55.03 years. The mean duration of disease was 10.31 months with mean follow-up period of 9.30 months. There was a mean gain of +6.00 ETDRS letters (p value = 0.0006) from the baseline mean visual acuity of 71.06 ETDRS letters. Central foveal thickness improved from baseline mean of 322.2 microns to final mean of 228.3 microns (reduction of 93.9 microns, p value = 0.0003). 74.2% (23 of 31) of patients had complete resolution of subretinal fluid with a single session of treatment. The mean number of treatment sessions delivered was 1.29. 100% of patients avoided a loss of 5 ETDRS letters or more at the final follow up appointment. No patient suffered complications from treatment.
Half-dose photodynamic therapy is an effective, safe and deliverable treatment for chronic central serous chorioretinopathy with anatomical and functional success in NHS hospitals. Our visual and anatomical outcomes are comparable to published literature.