Purpose:
To evaluate the outcomes of photodynamic therapy (PDT) vs. intravitreal bevacizumab in the treatment of central serous retinopathy (CSR).
Methods:
A retrospective, comparative study of consecutive patients with CSR treated with PDT or bevacizumab at a single retina practice. Inclusion criteria are age > 18y, presence of CSR by fluoroscein angiography, treatment with PDT or bevacizumab. Patients with follow-up < 6 months or patients with causes other than CSR were excluded. The outcomes studied include visual acuity, angiographic resolution, center point thickness (CPT) on OCT and number of treatments required.
Results:
Ten patients treated with PDT (group 1) and 10 patients treated with bevacizumab (group 2) were evaluated in the study. The mean age was 48 in both groups. The baseline visual acuity was 20/60 for group 1 and 20/80 for group 2. The mean final visual acuity was 20/50 for group 1 and 20/30 for group 2. Visual improvement in Group 1 was not statistically significant (p=0.82); there was a trend towards improvement in group 2 (p=0.13). On average, group 1 received 2.1 treatments of PDT, and group 2 received 3.8 bevacizumab injections. In group 1, 30% gained vision, 70% had no change in vision. In group 2, 100% of the patients had gained vision. There was complete angiographic resolution in both groups. CPT improved from a mean of 350um to 235um in group 1 and 408um to 179um in group 2. There were no complications associated with either of the groups.
Conclusions:
There was no significant improvement in vision in the PDT group. However, there is a trend towards visual improvement in patients receiving bevacizumab. This outcome appears to correlate with a reduction in subretinal and intraretinal fluid on OCT.
Keywords: retinal neovascularization • choroid: neovascularization • retinitis