Objective To observe the clinical effect of photodynamic therapy (PDT）based comprehensive treatment for choroidal neovascularization (CNV) in patients with multifocal choroiditis (MC). Methods Nine eyes of 8 MC patients (7 females and 1 male) with CNV who had undergone PDT based comprehensive treatment were enrolled in this study. The patients aged from 25 to 54 years with the mean of (41.8plusmn;10.6) years. The examinations of best-corrected visual acuity (BCVA), slit lamp microscope, indirect ophthalmoscopy, fundus fluorescein angiography and optical coherence tomography were performed. The BCVA ranged from 20/333 to 20/50 (mean logMAR 0.68plusmn;0.32). The mean CNV area was (0.767plusmn;0.445) mm2. The central retinal thickness (CRT) was (355.2plusmn;65.2) mu;m. Among the 8 patients,4 eyes received only PDT, 2 eyes received PDT and oral corticosteroid, 1 eye received PDT and intravitreal injection of 1.25 mg bevacizumab, 2 eyes received PDT and subtenon injection of 40 mg triamcinolone acetonide. The follow-up period ranged from 3 to 22 months, with the mean of (14.0plusmn;5.7) months. The BCVA, mean CNV area and CRT before and after treatment were analyzed. Results By the end of last visit, the BCVA improved to 20/250 to 20/25 (mean logMAR 0.58plusmn;0.37), but the difference was not statistically significant (t=1.890, P=0.095). Visual acuity improved 3 lines in 3 eyes (33.3%), improved 1.5 lines in 1 eye (11.1%), unchanged in 4 eyes (44.4%) and decreased 1.5 lines in 1 eye (11.1%). The mean CNV area decreased to (0.684plusmn;0.371) mm2, but the difference was not statistically significant (t=0.996, P=0.349). The CRT decreased to (295.3plusmn;79.4) mu;m, but the difference was not statistically significant (t=2.242, P=0.055). Conclusion PDT can stabilize visual acuity in patients with subretinal CNV secondary to MC, especially when combined with intravitreal injection of antivascular endothelial growth factor drugs or steroid.
Objective To observe the clinical effect of half-dose photodynamic therapy (PDT) for chronic central serous chorioretinopathy. Methods Thirty-two eyes of 27 patients (22 males and 5 females) with chronic central serous chorioretinopathy, diagnosed by best corrected visual acuity (BCVA) of logMAR, direct ophthalmoscope, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography, were enrolled. The age was ranged from 31 to 63 years old, with a mean of 45 years. The course of the disease was ranged from 6 to 32 months, with a mean of 16.2 months. The logMAR BCVA was 1.6 -0.1. The serous neuroepithelium detachment was found in 28 eyes, and serous neuroepithelium detachment combined with retinal pigment epithelium detachment (PED) was found in 4 eyes. The central retinal thickness was ranged from 184 to 465 mu;m, with a mean of 318.6 mu;m. All of the patients were treated with half dose PDT according to the methods in literatures. The above examinations were performed every 3 months after the treatment to observe the BCVA, subretinal fluid and retinal thickness. Results OCT showed that subretinal fluid were absorbed completely and retina remained attached in 25 of 28 eyes (89.3%) and 2 of 4 eyes (50.0%) with PED, while subretinal fluid were absorbed partly and retina attached incompletely in 3 of 28 eyes (10.7%) and 2 of 4 eyes (50.0%) with PED at the last visit. Twenty-seven eyes with retina remained attached, the mean central retinal thickness (CRT) decreased from (321.4plusmn;88.2) to (150.4plusmn;22.3) mu;m (t=9.09, P＜0.05); the mean logMAR BCVA improved from 0.68plusmn;0.09 to 0.44plusmn;0.07 (t=2.65,P＜0.05). Among those, logMAR BCVA within 0.32 were found in 12 eyes. There was a significant positive association between the CRT and BCVA (r=0.96, P＜0.01）. No recurrence or side effect was observed at the last visit. Conclusion Half-dose PDT is a safe and effective approach for chronic central serous chorioretinopathy, especially for those without PED.