Retrospective study of 30% and 50% dose verteporfin photodynamic therapy versus anti-vascular endothelial growth factor for chronic central serous chorioretinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

SongDan ,  ZhaoMingwei , JinEnzhong , 潘中婷 , 刘佩佩 , 姚昱欧 , 李宏彦 , 黎晓新

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

Corresponding author：

ZhaoMingwei, Email: zhaomingwei@medmail.com.cn

Keywords：

Central serous chorioretinopathy/therapy; Central serous chorioretinopathy/drug therapy; Photochemotherapy; Treatment outcome

DOI：

10.3760/cma.j.issn.1005-1015.2015.03.003

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Objective To compare the efficacy among 30% and 50% dose of verteporfin photodynamic therapy (PDT) and intravitreal anti-vascular endothelial growth factor (anti-VEGF) in the treatment of chronic central serous chorioretinopathy (CSC). Methods 138 eyes of 125 patients with chronic CSC, who were treated in our hospital from March 2006 to May 2014, were enrolled in this retrospective study. All patients were confirmed by spectral domain optical coherence tomography (SD-OCT) and best corrected visual acuity (BCVA), which was recorded with logMAR BCVA. And all the patients were divided into three groups by different treatments: 30% dose group (42 eyes of 39 patients); 50% dose group (77 eyes of 67 patients); anti-VEGF group (19 eyes of 19 patients). The differences of age, gender, eyes, courses, mean logMAR BCVA among three groups were not significant. Disappearing of fluid under retina in SD-OCT was considered to be cured and fluid remaining was not cured. If fluid appeared again the eyes were relapsed. We comparatively analyzed the cure rate, relapse rate and changing of BCVA, central macular thickness (CMT) among 3 groups of patients after 1, 3, 6 months. Results The cure rate among 3 groups after 1 month was statistically different (χ²=6.926, P=0.031). The cure rates of 50% dose PDT treatment group after 3 months and 6 months were better than 30% dose PDT treatment group, but the differences were not significant (χ²=2.218, 1.682; P=0.136, 0.195). The relapse rate between 30% dose and 50% dose PDT treatment groups after 3 months and 6 months were not significant (χ²=2.133, 3.366; P=0.144, 0.067). The improvement of BCVA in 50% dose PDT treatment group was the best, but comparing with the other two groups, the differences were not significant in statistics (P > 0.05). The improvement of CMT in 50% dose PDT treatment group was the best. Comparing with anti-VEGF group, the differences was significant (P < 0.05). But comparing with 30% dose PDT treatment group, the differences was not significant (P > 0.05). Logistic regression analysis showed that after treatment, the cure rates after 1 month and 6 months were negatively correlated with the age (regression coefficient=-0.942, -0.979; odds ratio=0.390, 0.375; P < 0.05) and the cure rates after 3 months was positively correlated with the dose of verteporfin (regression coefficient=0.855, odds ratio=2.351, P < 0.05). Conclusion 50% dose verteporfin PDT is recommend for chronic CSC treatment.

Citation： SongDan, ZhaoMingwei, JinEnzhong. Retrospective study of 30% and 50% dose verteporfin photodynamic therapy versus anti-vascular endothelial growth factor for chronic central serous chorioretinopathy. Chinese Journal of Ocular Fundus Diseases, 2015, 31(3): 221-225. doi: 10.3760/cma.j.issn.1005-1015.2015.03.003 Copy

1.	Chan WM, Lai TY, Lai RY, et al. Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy:one-year results of a randomized controlled trial[J]. Ophthalmology, 2008, 115(10):1756-1765.
2.	Al-Hinai AS, Al-Abri MS. Half-fluence photodynamic therapy to treat central serous chorioretinopathy:a case series[J]. Oman J Ophthalmol, 2011, 4(2):63-66.
3.	Nicholson B, Noble J, Forooghian F, er al. Central serous chorioretinopathy:update on pathophysiology and treatment[J]. Surv Ophthalmol, 2013, 58(2):103-126.
4.	Ruiz-Moreno JM, Lugo FL, Armada F, et al. Photodynamic therapy for chronic central serous chorioretinopathy[J]. Acta Ophthalmol, 2010, 88(3):371-375.
5.	Schaal KB, Hoeh AE, Scheuerle A, et al.Intravitreal bevacizumab for treatment of chronic central serous chorioretinopathy[J].Eur J Ophthalmol, 2009, 19(4):613-617.
6.	Lim SJ, Roh MI, Kwon OW. Intravitreal bevacizumab injection for central serous chorioretinopathy[J].Retina, 2010, 30(1):100-106.
7.	Chan WM, Lam DS, Lai TY, et al.Chorloidal 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(12):1453-1458.
8.	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(3):288-298.
9.	Park SU, Lee SJ, Kim M.Intravitreal anti-vascular endothelial growth factor versus observation in acute central serous chorioretinopathy:one-year results[J]. Korean J Ophthalmol, 2014, 28(4):306-313.
10.	Zhao MW, Zhou P, Xiao HX, et al. Photodynamic therapy for acute central serous cho rioretinopathy:the safe effective lowest dose of verteporfin[J]. Retina, 2009, 29(8):1155-1161.
11.	Otsuka S, Ohba N, Nakao K. A long-term follow-up study of severe variant of central serous chorioretinopathy[J]. Retina, 2002, 22(1):25-32.
12.	Cruess AF, Zlateva G, Pled AM, et al. Photodynamic therapy with verteporfin in age-related macuIar degeneration:a systematic review of efficacy, safety, treatment modifications and pharmacoeconomic properties[J]. Acta Ophthalmol, 2009, 87(2):118-132.
13.	郑红梅, 邢怡桥, 陈长征, 等.中心性浆液性脉络膜视网膜病变的光动力治疗[J].武汉大学学报:医学版, 2008, 29(2):251-252.
14.	Lee PY, Kim KS, Lee WK. Severe choroidal ischemia following photodynamic therapy for pigment epithelial detachment and chronic central serous chorioretinopathy[J]. Jpn J Ophthalmol, 2009, 53(1):52-56.
15.	Zhao M, Zhang F, Chen Y, et al. A 50% vs 30% dose of verteporfin (photodynamic therapy) for acute central serous chorioretinopathy:one-year results of a randomized clinical trial[J]. JAMA Ophthalmol, 2015, 133(3):333-340.
16.	李鹏程, 盛双燕, 彭冲, 等.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(4):327-330.

1. Chan WM, Lai TY, Lai RY, et al. Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy:one-year results of a randomized controlled trial[J]. Ophthalmology, 2008, 115(10):1756-1765.
2. Al-Hinai AS, Al-Abri MS. Half-fluence photodynamic therapy to treat central serous chorioretinopathy:a case series[J]. Oman J Ophthalmol, 2011, 4(2):63-66.
3. Nicholson B, Noble J, Forooghian F, er al. Central serous chorioretinopathy:update on pathophysiology and treatment[J]. Surv Ophthalmol, 2013, 58(2):103-126.
4. Ruiz-Moreno JM, Lugo FL, Armada F, et al. Photodynamic therapy for chronic central serous chorioretinopathy[J]. Acta Ophthalmol, 2010, 88(3):371-375.
5. Schaal KB, Hoeh AE, Scheuerle A, et al.Intravitreal bevacizumab for treatment of chronic central serous chorioretinopathy[J].Eur J Ophthalmol, 2009, 19(4):613-617.
6. Lim SJ, Roh MI, Kwon OW. Intravitreal bevacizumab injection for central serous chorioretinopathy[J].Retina, 2010, 30(1):100-106.
7. Chan WM, Lam DS, Lai TY, et al.Chorloidal 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(12):1453-1458.
8. 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(3):288-298.
9. Park SU, Lee SJ, Kim M.Intravitreal anti-vascular endothelial growth factor versus observation in acute central serous chorioretinopathy:one-year results[J]. Korean J Ophthalmol, 2014, 28(4):306-313.
10. Zhao MW, Zhou P, Xiao HX, et al. Photodynamic therapy for acute central serous cho rioretinopathy:the safe effective lowest dose of verteporfin[J]. Retina, 2009, 29(8):1155-1161.
11. Otsuka S, Ohba N, Nakao K. A long-term follow-up study of severe variant of central serous chorioretinopathy[J]. Retina, 2002, 22(1):25-32.
12. Cruess AF, Zlateva G, Pled AM, et al. Photodynamic therapy with verteporfin in age-related macuIar degeneration:a systematic review of efficacy, safety, treatment modifications and pharmacoeconomic properties[J]. Acta Ophthalmol, 2009, 87(2):118-132.
13. 郑红梅, 邢怡桥, 陈长征, 等.中心性浆液性脉络膜视网膜病变的光动力治疗[J].武汉大学学报:医学版, 2008, 29(2):251-252.
14. Lee PY, Kim KS, Lee WK. Severe choroidal ischemia following photodynamic therapy for pigment epithelial detachment and chronic central serous chorioretinopathy[J]. Jpn J Ophthalmol, 2009, 53(1):52-56.
15. Zhao M, Zhang F, Chen Y, et al. A 50% vs 30% dose of verteporfin (photodynamic therapy) for acute central serous chorioretinopathy:one-year results of a randomized clinical trial[J]. JAMA Ophthalmol, 2015, 133(3):333-340.
16. 李鹏程, 盛双燕, 彭冲, 等.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(4):327-330.

Chinese Journal of Ocular Fundus Diseases

Retrospective study of 30% and 50% dose verteporfin photodynamic therapy versus anti-vascular endothelial growth factor for chronic central serous chorioretinopathy

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