title: System review and meta-analysis on photodynamic therapy in central serous chorioretinopathy.
abstract: OBJECTIVE
  To evaluate the effect of photodynamic therapy (PDT) on central serous chorioretinopathy (CSC) compared with laser therapy and intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs, and to find the maximum treatment effect with minimal dose and fluence of PDT.
  
  
  METHODS
  A systematic electronic search was conducted in Feb 2013 in PubMed, Embase, ISI Web of Knowledge and the Cochrane library. The main outcome factors were compared in best-corrected visual acuity (BCVA), central macular thickness (CMT) and resolution of subretinal fluid (SRF). Meta-analysis was performed when it is appropriate. The comparisons were designed into four groups: group 1, PDT versus laser photocoagulation; group 2, PDT versus intravitreal injection of anti-VEGF drugs; group 3, half-dose verteporfin PDT versus placebo; group 4, half-fluence PDT versus full-fluence PDT.
  
  
  RESULTS
  We retrieved nine reports of studies including a total of 319 patients. In group 1, the summary result indicated that PDT was superior in resolution of SRF (p = 0.005) than laser photocoagulation. In group 2, PDT could resolute SRF (p = 0.007) and decrease CMT (p = 0.002) more rapidly than intravitreal injection of anti-VEGF drugs. In group 3, half-dose PDT was effective in improving BCVA (p < 0.00001), decreasing CMT (p = 0.001) and resolving SRF (p < 0.001). In group 4, half-fluence PDT was effective and could significantly decrease the hypoxic damage which was caused by PDT (p < 0.001).
  
  
  CONCLUSIONS
  PDT is a promising therapy for CSC patients and the parameters of PDT can be adjusted to obtain the maximum treatment effect with minimal adverse effects.
authors.affiliation: Department of Heallth Care, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Jinlan
authors.initials: J
authors.lastname: Ma
authors.forename: Nana
authors.initials: N
authors.lastname: Meng
authors.forename: Xiaoyi
authors.initials: X
authors.lastname: Xu
authors.forename: Fang
authors.initials: F
authors.lastname: Zhou
authors.forename: Yi
authors.initials: Y
authors.lastname: Qu
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D056833:Central Serous Chorioretinopathy / Q000175:diagnosis / Q000188:drug therapy*; D004396:Coloring Agents; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D017075:Laser Coagulation; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D014466:Ultraviolet Rays; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D000077362:Verteporfin; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000077362:Verteporfin; D007208:Indocyanine Green
keywords: central serous chorioretinopathy; meta-analysis; photodynamic therapy; system review; verteporfin