New Guidelines in the Treatment of Persistent Central Serous Chorioretinopathy: PDT with Half-Dose Verteporfin

Abstract

Background: In persistent central serous chorioretinopathy (CSC) resolution of detachment can be achieved by photodynamic therapy. Our objective was to evaluate the efficacy of half-dose verteporfin compared to full-dose verteporfin.

Patients and Methods: In 2009 the standard PDT regimen for CSC in our clinic was changed from full-dose to half-dose verteporfin. After a retrospective analysis 11 cases of half-dose PDT with documented course in 11 patients are presented. A comparison was performed with a control group of 11 consecutive patients with documented course who had received full-dose PDT before 2009.

Results: Prior to PDT there were no statistically significant differences between the groups concerning age, central foveal thickness, thickness of detachment, BCVA (EDTRS) and size of spot. 6 weeks after PDT a significant reduction of foveal thickness and detachment was detected in both groups, as well as a significant increase in BCVA. No statistically significant differences in outcome could be found between the two groups (Mann-Whitney U-test, p < 0.05).

Conclusions: PDT with half-dose verteporfin seems to be an effective and safe treatment for persistent CSC. Our data showed comparable results after half-dose and after full-dose PDT.

Zusammenfassung

Hintergrund: Photodynamische Therapie ist eine etablierte Therapiemöglichkeit bei persistierender CCS. Wir untersuchten die Wirksamkeit von halber Dosis Verteporfin im Vergleich zu voller Dosis.

Patienten und Methoden: Das PDT-Standardprotokoll für CCS wurde 2009 an unserer Klinik von voller zu halber Dosis Verteporfin geändert. Retrospektiv werden 11 Fälle mit dokumentiertem Verlauf nach halber Dosis präsentiert. Es erfolgte ein Vergleich mit einer Kontrollgruppe von 11 konsekutiven Patienten mit dokumentiertem Verlauf, die vor 2009 mit voller Dosis behandelt wurden.

Ergebnisse: Vor PDT bestanden zwischen den beiden Gruppen keine signifikanten Unterschiede hinsichtlich Alter, fovealer Netzhautdicke, Dicke der Abhebung, bestkorrigiertem Visus (EDTRS) und Spotgröße. 6 Wochen nach PDT fand sich in beiden Gruppen eine signifikante Reduktion der fovealen Netzhautdicke und der Abhebung sowie ein signifikanter Anstieg des Visus. Zwischen den beiden Gruppen zeigte sich kein statistisch signifikanter Unterschied im Outcome (Mann-Whitney-U-Test, p < 0,05).

Schlussfolgerungen: PDT mit halber Dosis Verteporfin scheint eine effektive und sichere Therapie der persistierenden CCS zu sein. Es fanden sich vergleichbare Resultate nach halber und nach voller Dosis Verteporfin.

Key words

central serous chorioretinopathy - photodynamic therapy - half-dose verteporfin

Schlüsselwörter

Chorioretinopathia centralis serosa - photodynamische Therapie - halbe Dosis Verteporfin

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