Outcomes of treatment of central serous chorioretinopathy with half-fluence half-dose photodynamic therapy

Theme: Retina*
What: Retina
Part of: Retina III: A Passionate Potpourri for Pinching Out Pathology / Rétine III: Pot-pourri passionné pour éliminer les pathologies
When: 6/2/2024, 11:15 AM - 12:45 PM
Where: Room | Salle 713 AB

Abstract

Purpose:

Photodynamic therapy (PDT) with verteporfin is an effective and relatively safe treatment for central serous chorioretinopathy (CSCR). Modifications to PDT protocols such as using half-dose verteporfin or half-fluence laser have shown comparable efficacy to standard PDT with better safety outcomes. It is hypothesized that the safety profile of PDT could be further ameliorated while maintaining efficacy via a half-dose, half-fluence approach. The purpose of this investigation is to determine outcomes in eyes with CSCR treated with a combination of half-dose and half-fluence PDT (half-half PDT).

Study Design:

Retrospective cohort review.

Methods:

This study included patients with CSCR treated with half-half PDT at Alberta Retina Consultants between September 2014 and July 2023. Exclusion criteria included any concomitant ocular disease or any history of ocular surgery, intraocular injection, or non-PDT laser therapy in the treated eye. Outcomes included visual acuity (VA), central subfield thickness (CST) and fluid resolution assessed at 3 months along with need for retreatment and reports of adverse events.

Results:

There were 352 patients who met eligibility criteria and 378 eyes included in the study. The mean age was 50.4 years old and there were 262 males (74%). A total of 31 patients (8.8%) were on steroids before treatment. The mean baseline visual acuity was 59.2 ETDRS letters and the mean baseline CST was 364.3 microns. Post treatment there was a mean gain of 14.0 ETDRS letters (p<0.05). The mean CST decreased by 83.1 microns (p<0.05). There was complete resolution of subretinal fluid by 3 months post treatment in 212 eyes (50.8%). A second treatment was required in 135 eyes (35.7%). There were 13 eyes (3.4%) which developed choroidal neovascularization at some point during follow up post-PDT treatment.

Conclusions:

PDT is a mainstay of treatment for CSCR. We describe a cohort of patients who received half-dose and half-fluence PDT for CSCR with improvement in both BCVA and CST. We highlight that half and half PDT is an alternative treatment for CSCR but may not be as effective as half-dose PDT.

Presenter(s)

Presenting Author: Deven Deonarain

Additional Author(s):

Amit Mishra, University of Alberta, Alberta Retina Consultants

Graeme Loh, University of Alberta, Alberta Retina Consultants

Matthew Tennant, University of Alberta, Alberta Retina Consultants

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