Retrospective study of low-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

PanZhongting ,  ZhaoMingwei , DongChongya , 曲进锋 , 李宏彦 , 魏航 , 李岩 , 刘国栋 , 徐秀兰 , 李春安 , 刘佩佩 , 张丽娟 , 黎晓新

Department of Ophthalmology, Peking University People's Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100044, China;

Corresponding author：

ZhaoMingwei, Email: zhaomingwei@medmail.com.cn

Keywords：

Central serous chorioretinopathy/therapy; Photosensitizing agents/administration & dosage; Photochemotherapy; Treatment outcome

DOI：

10.3760/cma.j.issn.1005-1015.2014.04.009

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Objective To evaluate the efficacy of 30% and 50% dose photodynamic therapy (PDT) for acute central serous chorioretinopathy (CSC). Methods A retrospective cohort study. Ninety-two eyes of 88 patients with CSC, diagnosed by best corrected visual acuity (BCVA) of logarithm of the minimum angle of resolution (logMAR), indirect ophthalmoscope, fundus colorized photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA)and optical coherence tomography (SD-OCT) treated with 30% and 50% doses of verteporfin respectively between March 2007 and August 2013, were enrolled. The eyes were divided into 50% dose group (49 eyes) and 30% dose group (43 eyes). The differences of age (t=-1.45), gender (χ²=0.011), eyes (χ²=2.140), mean logMAR BCVA (t=-0.40), mean central retinal thickness (CRT) and the maximum thickness of serous retinal detachment (SRD) between two groups were not significant (P > 0.05). The difference of spot size between two groups was significant (t=-2.84, P < 0.05). The follow-up time was ranged from 6 to 68 months, with a mean of (17.16 ±11.30) months. The difference of follow-up between two groups was significant (P > 0.05). The BCVA, cure rate, recurrence rate and the changes of CRT and maximum SRT were observed by SD-OCT. Results The subretinal fluid (SRF) of 31 eyes (72.09%) in the 30% dose group and that of 47 eyes (95.92%) in the 50% dose PDT group was absorbed completely respectively. The cure rates in the 30% dose PDT group was significantly less than that in the 50% dose group (χ²=10.077, P=0.020). There was a significant negative association between the cure rate and spot size by Logistic regression (odds ratio > 1, P=0.040). The difference of changes in the BCVA of logMAR in 50% dose group was better than that in 30% dose group after more than 12 months after PDT (P=0.036). On 3, 6, 12 and more than 12 months after PDT, the difference in CRT in 50% dose group and 30% dose group were not statistically significant (P=0.068, 0.060, 0.082, 0.067). The difference in maximum thickness of SRD was not statically significant (P > 0.05). SRF was appeared in 8 eyes (25.81%) of 31 eyes in the 30% dose group, while SRF was appeared in 1 eye (2.13%) of 47 eyes in the 50% dose group. The recurrence rate of 30% dose group was much higher than that of 50% dose group (P < 0.05). Conclusions For acute CSC treated by PDT, the curative effect of 50% dose group is better than the 30% dose group.

Citation： PanZhongting, ZhaoMingwei, DongChongya. Retrospective study of low-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy. Chinese Journal of Ocular Fundus Diseases, 2014, 30(4): 369-373. doi: 10.3760/cma.j.issn.1005-1015.2014.04.009 Copy

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3.	Zhao MW, Zhou P, Xiao HX, et al. Photodynamic therapy for acute central serous chorioretinopathy: the safe effective lowest dose of verteporfin [J]. Retina, 2009, 29:1155-1161.
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6.	Cruess AF, Zlateva G, Pleil AM, et al. Photodynamic therapy with verteporfin in age-related macular degeneration: a systematic review of efficacy, safety, treatment modifications and pharmacoeconomic properties[J]. Acta Ophthalmol, 2009, 87: 118-132.
7.	Gass JDM. Pathogenesis of disciform detachment of the neuroepithelium Ⅱ: idiopathic central serous choroidopathy[J]. Am J Ophthalmol, 1967, 63:587-615.
8.	Folk JC, Thompson HS, Han DP, et al. Visual function abnormalities in central serous retinopathy[J]. Arch Ophthalmol, 1984, 102:1299-1302.
9.	Levine R, Brucker A, Robinson F. Long-term follow-up of idiopathic central serous chorioretinopathy by fluorescein angiography[J]. Ophthalmology, 1989, 96:854-859.
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11.	李鹏程, 盛双燕.半剂量光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变[J].中华眼底病杂志, 2011, 27:327-330.
12.	Spaide RF, Campeas L, Haas A, et al. Central serous chorioretinopathy in younger and older adults [J]. Ophthalmology, 1996, 103: 2070-2080.
13.	郑波, 樊小娟. 1/3量维替泊芬光动力学疗法治疗急性中心性浆液性脉络膜视网膜病变[J].国际眼科杂志, 2013, 13:1625-1627.
14.	廖燕红, 周宏建.半剂量维替泊芬光动力疗法治疗纤维蛋白沉积为主的中心性浆液性脉络膜视网膜病变二例[J].中华眼底病杂志, 2011, 27: 294-295.
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1. Otsuka S, Ohba N, Nakao K. A long-term follow-up study of severe variant of central serous chorioretinopathy[J]. Retina, 2002, 22:25-32.
2. Chan WM, Lam DS, Lai TY, et al. Choroidal vascular remodelling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level [J]. Br J Ophthalmol, 2003, 87:1453-1458.
3. Zhao MW, Zhou P, Xiao HX, et al. Photodynamic therapy for acute central serous chorioretinopathy: the safe effective lowest dose of verteporfin [J]. Retina, 2009, 29:1155-1161.
4. Yannuzzi LA, Slakter JS, Gross NE, et al. Indocyanine green angiography-guided photodymanic therapy for treatment of chronic central serous chorioretinopathy: a pilot study [J]. Retina, 2003, 23:288-298.
5. Costa RA, Scapucin L, Moraes NS, et al. Indocyanine green-mediated photothrombosis as a new technique of treatment for persistent central serous chorioretinopathy[J]. Curr Eye Res, 2002, 25:287-297.
6. Cruess AF, Zlateva G, Pleil AM, et al. Photodynamic therapy with verteporfin in age-related macular degeneration: a systematic review of efficacy, safety, treatment modifications and pharmacoeconomic properties[J]. Acta Ophthalmol, 2009, 87: 118-132.
7. Gass JDM. Pathogenesis of disciform detachment of the neuroepithelium Ⅱ: idiopathic central serous choroidopathy[J]. Am J Ophthalmol, 1967, 63:587-615.
8. Folk JC, Thompson HS, Han DP, et al. Visual function abnormalities in central serous retinopathy[J]. Arch Ophthalmol, 1984, 102:1299-1302.
9. Levine R, Brucker A, Robinson F. Long-term follow-up of idiopathic central serous chorioretinopathy by fluorescein angiography[J]. Ophthalmology, 1989, 96:854-859.
10. Wang MS, Sander B, Larsen M. Retinal atrophy in idiopathic central serous chorioretinopathy[J]. Am J Ophthalmol, 2002, 133:787-793.
11. 李鹏程, 盛双燕.半剂量光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变[J].中华眼底病杂志, 2011, 27:327-330.
12. Spaide RF, Campeas L, Haas A, et al. Central serous chorioretinopathy in younger and older adults [J]. Ophthalmology, 1996, 103: 2070-2080.
13. 郑波, 樊小娟. 1/3量维替泊芬光动力学疗法治疗急性中心性浆液性脉络膜视网膜病变[J].国际眼科杂志, 2013, 13:1625-1627.
14. 廖燕红, 周宏建.半剂量维替泊芬光动力疗法治疗纤维蛋白沉积为主的中心性浆液性脉络膜视网膜病变二例[J].中华眼底病杂志, 2011, 27: 294-295.
15. Prunte C, Flammer J. Choroidal capillary and venous congestion in central serous chorioretinopathy [J].Am J Ophthalmol, 1996, 121:26-34.

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