Clinical research on one-third dose verteporfin photodynamic therapy in the treatment of chronic central serous chorioretinopathy

L. Hua, B. Lin, J. Hong, H.-B. Min, W.-L. Han, T.-Y. Zhou, Z.-Q. Zhang

Department of Ophthalmology, The Bayi Hospital Affiliated Nanjing University of Chinese Medicine, Nanjing, China. flower19831@163.com

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• Ophthalmology

OBJECTIVE: To observe the curative effect and safety of one-third dose Verteporfin photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSC).

PATIENTS AND METHODS: A total of 60 patients (68 eyes) treated in our hospital from January 2016 to December 2016 were selected in this study, and they were diagnosed with chronic CSC via fluorescein fundus angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). Besides, patients were treated with one-third conventional dose Verteporfin PDT. The subfoveal choroidal thickness (SFCT), superior, inferior, nasal and temporal choroidal thickness at 1.5 mm away from macula central fovea, central choroidal capillary layer thickness, photoreceptor layer thickness, best corrected visual acuity (BCVA), subretinal fluid absorption, FFA and ICGA manifestations and complications of patients were observed and recorded before treatment and at 1, 3 and 6 months after treatment.

RESULTS: After PDT via one-third conventional dose of Verteporfin, patients were followed up for 1 month, 3 months, and 6 months. The SFCT of affected eyes was changed from (381.23 ± 83.29) μm before treatment to (385.31 ± 90.89) μm, (369.59 ± 75.60) μm and (374.08 ± 102.81) μm successively, and the differences were statistically significant (p < 0.001). Central choroidal capillary layer thickness and superior, inferior, nasal and temporal choroidal thickness at 1.5 mm away from macula central fovea (SCT1.5mm, ICT1.5mm, NCT1.5mm and TCT1.5mm) were significantly decreased at 1 month, 3 months and 6 months after treatment compared with those before treatment (p < 0.001). With the passage of time after treatment, the photoreceptor layer thickness of affected eyes was increased gradually, and the difference was statistically significant (F = 268.8, p < 0.0001). After PDT, BCVA had a statistically significant difference compared with that before treatment (p = 36.16, p < 0.001); BCVA at 3 months after treatment had no statistically significant difference compared with that at 6 months after treatment (p > 0.05). At 6 months after treatment, the subretinal fluid in 63 eyes (92.6%) completely subsided, and a little subretinal fluid was retained in 5 eyes (7.4%). FFA and ICGA showed the choroidal vessel dilatation in affected eyes after treatment and significantly improved moderate-advanced high fluorescein leakage compared with that before treatment. There were no obvious complications in the body and fundus during the follow-up period.

CONCLUSIONS: One-third dose Verteporfin PDT can improve BCVA, stop or reduce the choroidal vasodilatation and leakage, accelerate the absorption of serous subretinal fluid, and help the recovery of photoreceptor layer of patients with chronic CSC, which is safe and reliable.

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