Abstract
Purpose :
To compare the anatomic and functional efficacy of intravitreal anti-vascular endothelial growth factor (VEGF) versus half-dose photodynamic therapy (PDT) treatment in central serous chorioretinopathy (CSC) with flat irregular pigment epithelium detachment (fiPED).
Methods :
This retrospective, interventional, comparative study included 72 treatment naive patients with CSC who exhibited fiPED. Among 75 eyes from 72 patients, 42 eyes from 41 patients received anti-VEGF treatment and 33 eyes from 31 patients received half-dose PDT. Treatment outcomes, including the visual acuity, central retinal thickness (CRT), and presence of subretinal fluid (SRF) were evaluated at baseline and 1, 6, 12 and 24 months after treatment and compared between two groups.
Results :
There were no differences in baseline characteristics between the two groups. In both groups, a significant improvement of CRT was observed at 1 month after treatment and was maintained throughout the 24-month follow-up period (P < 0.01). Whereas 10 out of 42 eyes (23.8%) with anti-VEGF treatment (mean 6.1 injections/ 2 years) required the alternative treatments (6 with PDT and 4 with focal laser), 1 out of 33 eyes (6.0%) with PDT treatment (mean 1.0 treatment/ 2 years) received focal laser treatment. In addition, PDT group showed significantly higher percentage of SRF resolution than anti-VEGF group (P < 0.05, PDT : 93.75%, anti-VEGF : 45.24% at 12-month follow-up), with lower recurrence rate of SRF (P < 0.05, PDT : 13.8%, anti-VEGF : 68.75% at 24-month follow-up). Likewise, the visual outcome had the similar trend with the anatomic outcomes.
Conclusions :
While treatment responses to anti-VEGF and PDT were favorable in CSC with fiPED, PDT treatment showed faster recovery of functional and anatomic outcomes with the lower recurrence, compared with anti-VEGF.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.