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Three-Year Results of Fluorescein Angiography–Guided Standard Photodynamic Therapy with Multiple Spots for Central Serous Chorioretinopathy

Published:December 29, 2017DOI:https://doi.org/10.1016/j.oret.2017.11.008

      Purpose

      To report the long-term results of fluorescein angiography (FA)-guided standard photodynamic therapy (PDT) for central serous chorioretinopathy (CSCR) and its adverse effects.

      Design

      Prospective, noncomparative, interventional study.

      Participants

      Consecutive patients (N = 63 eyes) with acute (39 eyes) or chronic (24 eyes) CSCR.

      Methods

      All eyes underwent FA-guided conventional PDT, using multiple spots in 1 session if appropriate, and were assessed before PDT, as well as at months 3, 6, and 12 after PDT, and every 6 months thereafter until the end of the 3-year follow-up time.

      Main Outcome Measures

      Primary outcome measures were the resolution of subretinal fluid (SRF) and the improvement of the Snellen best-corrected visual acuity (BCVA) to better than 20/100 at the end of the study. Secondary outcomes were the changes in mean BCVA and central foveal thickness (CFT) during the follow-up time.

      Results

      All 63 eyes with acute or chronic CSCR demonstrated complete resolution of SRF at the end of the study. Of the studied eyes, 51 (80.95%) underwent a single PDT application. The mean CFT improved significantly at all time points in the acute CSCR group (P < 0.001) from 515.13±110.5 μm to 297.75±22.3 μm at 3 years and in the chronic CSCR group from 484.12±62.49 μm to 293.81±16.89 μm. At 3 years, a gain of more than 20/100 in Snellen BCVA was seen in 28 acute and 16 chronic CSCR PDT-treated eyes (71.8% vs. 66.67%; P = 0.779). The mean logarithm of the minimum angle of resolution BCVA improved from 0.349±0.18 at baseline to 0.060±0.06 at the end of the study (P < 0.001) for eyes with acute CSCR and from 0.502±0.28 to 0.198±0.11 correspondingly for the eyes with chronic CSCR (P < 0.001). None of the study eyes demonstrated any serious systemic or ophthalmologic complication related to the use of the standard PDT with verteporfin.

      Conclusions

      Fluorescein angiography–guided conventional PDT achieved outcomes for acute and chronic CSCR comparable with those reported with modified PDT techniques. We did not identify new safety concerns.

      Abbreviations and Acronyms:

      BCVA (best-corrected visual acuity), CFT (central foveal thickness), CNV (choroidal neovascularization), CSCR (central serous chorioretinopathy), FA (fluorescein angiography), ICGA (indocyanine green angiography), logMAR (logarithm of the minimum angle of resolution), PDT (photodynamic therapy), RPE (retinal pigment epithelium), SD (spectral-domain), SRF (subretinal fluid)
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