Journal Article

Safety enhanced photodynamic therapy with half dose verteporfin for chronic central serous chorioretinopathy: a short term pilot study

Li, H, Chan, W-M, Lai, R Y K, Lam, D S C, Liu, D T L, Lai, T Y Y

2006

Overview

Aim: To evaluate short term safety of an enhanced photodynamic therapy (PDT) protocol with half dose verteporfin for treating chronic central serous chorioretinopathy (CSC). Methods: 20 eyes of 18 patients with symptomatic chronic CSC underwent PDT using 3 mg/m2 verteporfin. Verteporfin was infused over 8 minutes followed by indocyanine green angiography guided laser application 2 minutes later. Serial optical coherence tomography (OCT) and multifocal electroretinography (mfERG) recordings were performed before PDT, at 4 days, 2 weeks, and 1 month after PDT. The best corrected visual acuity (BCVA), OCT central retinal thickness, and mean mfERG response amplitudes and peak latencies were compared longitudinally. Subgroup analysis was further performed for eyes with or without pigment epithelial detachment (PED). Results: At 1 month after PDT, the median BCVA improved from 20/40 to 20/30 (p = 0.001). The mean central retinal thickness also reduced from 276 μm to 158 μm (p<0.001) and 17 (85%) eyes had complete resolution of serous retinal detachment and/or PED. MfERG showed no significant changes in the mean N1 and P1 response amplitude and latency for all eyes. Subgroup analysis demonstrated that eyes without PED had a significant increase in the mean central mfERG P1 response amplitude with reduction in P1 peak latency at 1 month post-PDT. For eyes with PED, transient reduction in the mean central P1 response amplitude was observed at 4 days post-PDT. Conclusions: The modified safety enhanced PDT protocol with half dose verteporfin appeared to be a beneficial treatment option for patients with chronic CSC, especially in eyes without serous PED. Further controlled study is warranted to demonstrate the long term safety and efficacy of this treatment option.

• Publisher: BMJ Publishing Group Ltd,BMJ,BMJ Publishing Group LTD,BMJ Group
• Subject: Adult / BCVA / best corrected visual acuity / Biological and medical sciences / central serous chorioretinopathy / Choroid Diseases - drug therapy / Choroid Diseases - pathology / Choroid Diseases - physiopathology / choroidal neovascularisation / Chronic Disease / Clinical Science - Extended Report / CNV / CSC / Diseases of the skin. Cosmetics / Drug Administration Schedule / Electroretinography / Female / Fluorescein Angiography / Humans / ICGA / indocyanine green angiography / International Society for Clinical Electrophysiology of Vision / ISCEV / Laboratories / Light / Macular degeneration / Male / Medical imaging / Medical sciences / mfERG / Middle Aged / Miscellaneous / multifocal electroretinography / OCT / Ophthalmology / optical coherence tomography / PDT / PED / Photochemotherapy - methods / Photodynamic therapy / Photosensitizing Agents - administration & dosage / Photosensitizing Agents - therapeutic use / pigment epithelial detachment / Pilot Projects / Porphyrins - administration & dosage / Porphyrins - therapeutic use / Prospective Studies / Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) / Retina - pathology / Retinal Detachment - drug therapy / Retinal Detachment - pathology / Retinal Detachment - physiopathology / retinal pigment epithelium / Retinopathies / RPE / SRF / Studies / subretinal fluid / Tomography, Optical Coherence / Verteporfin / Visual Acuity - drug effects