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Zhihang Cheng, Salma Babiker, Pauline Lenfestey, Nick Beare, Ian A Pearce; Long-term Outcomes of Half-dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5002.
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Half-dose verteporfin photodynamic therapy (half-dose PDT) is an established treatment for chronic central serous chorioretinopathy (CSCR), with well known short-term visual benefits. However there is limited data in the long-term benefits of half-dose PDT. This retrospective interventional case series at a tertiary ophthalmology department looks into the 2 year outcomes of patient who had half dose photodynamic therapy (PDT), and factors that may affect outcomes post treatment.
Patients with chronic CSCR treated with half-dose PDT between 9/2014 and 11/2016 were followed-up for 2 years. Outcome measures included resolution of sub-retinal fluid (SRF), change in best-corrected visual acuities (BCVAs), change in central foveal thickness (CFT) and recurrence rate of CSCR at 2 years after treatment.Diagnosis was made with spectral domain optical coherence tomography (SdOCT), fluorecein (FFA) and indocyanine green angiography (ICG) at time of treatment. All patients had BCVA in ETDRS letters. All CFT was measured with SdOCT.
Total of 20 eyes in 16 patients were followed up for an average of 26.9 months(22-35 months).At 2 year follow-up after PDT, 13 eyes (65%) achieved complete resolution of SRF, 18 eyes (90%) had an partial improvement of central foveal thickness (CFT) on SdOCT.At 2 year follow-up after PDT, 6 eyes (30%) had improved BCVA of more than 5 ETDRS letters and 10 eyes (50%) had stable BCVA of change of 5 letters or less. 4 eyes (20%) had a reduction of BCVA of more than 5 ETDRS letters.At 2 year follow-up after PDT, 5 eyes (25%) had a recurrence of SRF.Within the 2 year follow-up period, 7 eyes (35%) developed secondary choroidal neovascularisation (CNV) which required intra-vitreal Anti-VEGF treatment. Of the patients who developed secondary CNV, 5 of 7 eyes (71.4%) had persistent SRF whereas in patient without secondary CNV, 2 of 13 eyes (15.4%) has persistent SRF (p=0.0223). However, the average gain of BCVA was similar in eye with secondary CNV (1.14 letters) and without (1.08 letters)(p=0.994).
Half-dose PDT provides long-term improvements to SRF, CFT and stable vision. A significant proportion of patients has developed secondary CNV within 2 years of treatment, and this is associated with persistent SRF, however this does not significant alter their long-term visual outcomes.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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