Half-fluence versus half-dose photodynamic therapy in chronic central serous chorioretinopathy.
OBJECTIVE
To compare the efficacy and safety of half-fluence vs half-dose photodynamic therapy (PDT) in chronic central serous chorioretinopathy (CSC).


METHODS
Multicenter retrospective comparison study.


METHODS
Retrospective review of 56 patients affected by chronic CSC, including 28 patients (31 eyes) who received half-fluence PDT and 28 patients (29 eyes) who received half-dose PDT. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), and resolution of subretinal fluid on optical coherence tomography at 1 and 12 months were assessed.


RESULTS
The mean logMAR BCVA improved significantly (P < .001), both in the half-fluence group (from 0.187 [± 0.187] to 0.083 [± 0.164]) and in the half-dose group (from 0.126 [± 0.091] to 0.068 [± 0.091]), at 12 months, without significant difference between the 2 groups. At 1 month a complete resolution of subretinal fluid was observed in 19 half-fluence-treated eyes (61.3%) and in 25 half-dose-treated eyes (86.2%) (P = .04). At 12 months, a complete resolution of subretinal fluid was achieved in 26 half-fluence-treated eyes (83.9%) and 29 half-dose-treated eyes (100%) (P = .0529). Nine eyes (29%) in the half-fluence group and 5 eyes (17.2%) in the half-dose group had at least 1 recurrence of subretinal fluid during the follow-up. Overall there were 15 and 5 recurrences in the half-fluence PDT and half-dose PDT groups, respectively (P = .07). In no eye of either groups was atrophy of the retinal pigment epithelium observed in the area of treatment.


CONCLUSIONS
Half-dose PDT induced a more rapid reabsorption of the fluid, a more lasting effect, and equal safety with respect to half-fluence PDT.
Clinica Oculistica Università di Genova, Dipartimento di Neuroscienze, Oftalmologia, Genetica e Scienze Materno Infantili, Genova, Italy; Fondazione per la Macula Onlus, Genova, Italy. Electronic address: massimonicolo@occhioallaretina.it.
Massimo
M
Nicoló
Fondazione per la Macula Onlus, Genova, Italy; Clinica Oculistica - Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy.
Chiara M
CM
Eandi
Clinica Oculistica - Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy.
Camilla
C
Alovisi
Clinica Oculistica - Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy.
Federico M
FM
Grignolo
Clinica Oculistica Università di Genova, Dipartimento di Neuroscienze, Oftalmologia, Genetica e Scienze Materno Infantili, Genova, Italy.
Carlo Enrico
CE
Traverso
Clinica Oculistica Università di Genova, Dipartimento di Neuroscienze, Oftalmologia, Genetica e Scienze Materno Infantili, Genova, Italy.
Donatella
D
Musetti
Fondazione per la Macula Onlus, Genova, Italy.
Felice
F
Cardillo Piccolino
D056833:Central Serous Chorioretinopathy / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002908:Chronic Disease; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use; D011166:Porphyrins / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D058471:Subretinal Fluid / Q000378:metabolism; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D007208:Indocyanine Green