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Youngdo Yeo, Kwang-Soo Kim, Yu Cheol Kim; Photodynamic Therapy and Focal Laser Photocoagulation in Chronic Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5685.
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To compare the treatment efficacy of photodynamic therapy (PDT) and direct focal laser photocoagulation in chronic central serous chorioretinopathy (CSC).
Forty eyes of 40 patients with chronic CSC treated with PDT or direct focal laser photocoagulation were evaluated retrospectively. Mean change in best corrected visual acuity (BCVA), whether resolution of subretinal fluid (SRF) and pigment epithelium detachment (PED) or not, recurrence rate, and complications were analyzed. PDT was done at dilated choroidal vessel site on indocyanine green angiography with the mode setting of 1/2~2/3 power, full time, and full dose. Focal laser photocoagulation was done at early hyperfluorescent spot detected on fluorescein angiography with the 80-150 mW power and 80-100ms time setting, and if the leaking point located within 300 um of central macula, indirect focal laser photocoagulation was done at the just periphery.
PDT was performed in 23 eyes of 23 patients (group I), and focal laser photocoagulation was done in 17 eyes of 17 patients (group II), and all patients were followed up more than 6 months. Both groups showed that BCVA (log MAR) improved significantly at 1 month after therapy, however, there was no statistically significant differences of BCVA improvement in group comparison. Both groups showed that SRF and PED were partially or completely resolved, however, no statistically significant difference of resolution period was found between the groups. No patient experienced adverse events in group I, and 1 patient developed choroidal neovascularization (CNV) after treatment at the area of previous laser treatment in group II. Two patients were recurred in group I and none in group II.
Both PDT and direct focal laser photocoagulation are considered to be beneficial treatment in patients with chronic CSC. Focal laser photocoagulation before PDT is a good treatment option in a aspect of cost-effectiveness and conveniency.
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