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Yong Un Shin, Byung Ro Lee, Dong Eik Lee; Choroidal thickness after treatment of chronic central serous chorioretinopathy: half-fluence photodynamic therapy versus intravitreal injection of bevacizumab. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5863.
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There has been no report comparing the effect on choroid between intravitreal injection of bevacizumab (IVB) and half-fluence photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC). We investigated the change of choroidal thickness obtained by enhanced depth imaging (EDI) technique between two treatments.
For clinical diagnosis of CSC, each subject underwent comprehensive ophthalmological examination and imaging studies including fundus photography, spectral domain optical coherence tomography (SD-OCT) with EDI-technique, fluorescein angiography (FA), and indocyanine green angiography (IA). Of enrolled eyes with chronic CSC, 11 eyes were treated with an intravitreal injection of 0.05 ml (1.25 mg) of bevacizumab (IVB group) and 8 eyes were treated with half-fluence PDT (PDT group). Subfoveal choroidal thickness (CT) was measured before, 1 month and 3 months after treatment.
Of eyes treated with IVB, 5 eyes showed persistent serous retinal detachment (SRD), while all eyes treated with PDT showed complete resolution of SRD at 3 months follow-up visit. Before treatment, mean subfoveal CT was 382.0±66.64 and 390.13±49.60 in IVB group and PDT group respectively (p = 0.057). After treatment, subfoveal CT in both groups was decreased compared to those before treatment. Mean subfoveal CT in IVB group was 370.20±75.78 at 1 month and 355.0±57.54 at 3 months, which was not statistically significant (p=0.202, 0.160). On the other hand, PDT group showed a statistically significant decrease in CT at 1 month (325.13 ± 45.57, p = 0.028) and 3 months (326.86 ± 50.46, p=0.043). The change of choroidal thickness was more pronounced in PDT group than in IVB group.
This is the first report to compare choroidal thickness between before and after IVB or PDT for treatment of chronic CSC. Half-fluence PDT is more effective to reduce choroidal thickness than IVB in chronic CSC. Our study suggests half-fluence PDT may show better therapeutic effect than IVB because of the difference of effect on the choroid.
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