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F. Boscia, M. Reibaldi, G. Besozzi, N. Cardascia, C. Furino, S. Faro, M. Uva, G. Sborgia, A. Reibaldi, C. Sborgia; PDT Low-Dose, Low-Fluence Rate for Chronic Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1348.
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Purpose of the present study is to investigate the efficacy and the rate of side-effects of PDT therapy with low-fluence rate and half-dose verteporfin PDT for treatment of chronic CSC as compared with low-fluence rate PDT verteporfin therapy.
Eight eyes with chronic CSC, receiving half-dose (3 mg/m2) low-fluence rate (fluence 25 J/cm2, light dose rate: 300 mW/cm2) PDT with verteporfin (study group), were retrospectively compared with a control group of 8 eyes receiving standard-dose low-fluence rate verteporfin PDT. Inclusion criteria were: best-corrected visual acuity (BCVA) between 0,2 and 1 logMAR; presence of subretinal fluid and/or serous pigment epithelial detachment on OCT without regression for ≥3 months, RPE leakage on fluorescein angiography and choroidal vascular hyperpermeability on confocal scanning laser indocyanine green angiography (SLO-ICGA). Exclusion criteria were: any previous treatment for CSC; other chorioretinal disorders; media opacities; and treatment with steroids. Laser irradiation was applied on areas of choroidal vascular hyperpermeability, as observed on ICGA. Primary outcome measures were: far (using ETDRS charts) and near BCVA (using MNRead Acuity Charts), central macular thickness (OCT3, Zeiss-Humphrey). Secondary outcome measures were macular sensitivity and stability of fixation determined using microperimetry (Nidek MP1). All outcome measures were evaluated at baseline and 1, 4, and 12 weeks after treatment.
At baseline, the two groups were similar for all the functional and anatomic characteristics examined. In both groups, an improvement of far and near BCVA were seen in comparison with baseline (ANOVA, p<0,05 for all measurements). In all eyes a complete resolution of subretinal fluid was observed, with a significant reduction of central macular thickness. On week 12, in both groups, a significant improvement in mean fixation stability was also observed (p<0,05 for both groups). No significant difference in any parameter was observed at any timepoint between the two groups. No recurrence and/or adverse event occurred in any patient during the 12-week follow-up.
At 12 weeks, low fluence rate, half-dose verteporfin PDT is as effective and safe for treating chronic CSC, as low-fluence rate PDT.
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