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Jose A Cardillo, Leticia Barroso, Murilo Wendeborn Rodrigues, Rodrigo Jorge, Acacio Lima; Reduced-Dose Indocyanine Green Photodynamic Therapy (iPDT) as an Optimized Treatment for Chronic Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):201.
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To assess the efficacy and safety of reduced-dose Indocyanine green photodynamic therapy (iPDT) in patients with chronic central serous chorioretinopathy (CCSC) with no spontaneous resolution 6 months after the onset of the disease.
Twelve patients with CCSC presenting with persistent subretinal fluid in optical coherence tomography (OCT) six months after presentation and decrease in visual acuity (VA) were submitted to a single iPDT session with 1.5 mg/kg body weight indocynine green (ICG) and application of 4.5 W/cm2 light at 810 nm. A continuous follow-up was provided with best-corrected ETDRS VA assessment, and angiographic and OCT documentation 72 hours before and at 7 days, 1 and 2 weeks, 1, 3, 6, and 12 months after treatment.
Ten out of twelve patients presented with VA levels of ≥20/25 2 weeks after treatment; the mean logMAR VA change of 0.345 at that time was statistically significant (p < 0.05, Friedman test). OCT disclosed resolution of persistent sub-retinal fluid in all eyes. No recurrence was observed after 12 months of follow-up. No treatment-related complications were observed during the study period.
Photodynamic therapy using low-intensity 810nm light to direct laser energy continuously at the active leakage sites after intravenous ICG infusion induced rapid and sustained VA recovery in patients with CCSC. In parallel with to new pharmacologic agents for the treatment of CCSC, developments in new laser technologies, exploiting optimized parameters and treatment guidelines will be the key to progress CCSC treatment approaches for an ultimate anatomical and functional restoration
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