Hirotaka Yokouchi, Masayasu Kitahashi, Mariko Kubota, Takayuki, Baba, Shuichi Yamamoto
RETINAL SENSITIVITY CHANGES AFTER HALF-TIME REDUCED-FLUENCE PHOTODYNAMIC THERAPY FOR CENTRAL SEROUS CHORIORETINOPATHY
Purpose. To determine the effect of half-time reduced-fluence photodynamic therapy (RF-PDT) on macular function in eyes with chronic central serous chorioretinopathy (CSC).
Methods. Twenty-one eyes from 21 patients with chronic CSC of 6 months or more duration were studied. The dose and fluence of RF-PDT was administered according to the standard protocol for age-related macular degeneration (AMD), and laser was applied for 42 seconds guided by indocyanine green (ICG) angiographic images. The best-corrected visual acuity (BCVA) and the retinal sensitivity in the central 2- and 10-degrees were determined at the baseline and at 1, 3 and 6 months after the half-time RF-PDT. The retinal sensitivity was determined by Macular ntegrity Assessment microperimetry (MAIA, Centervue, Padova, Italy). Changes of the foveal thickness (CFT) and central choroidal thickness (CCT) were determined by optical coherence tomography (OCT).
Results. At the baseline, the mean retinal sensitivity was 19,0±4,60 dB in the central 2 degrees and 21,3±3,45 dB in the central 10 degrees.
After half-time RF-PDT, the mean retinal sensitivity improved significantly to 22,5±3,54 dB in the central 2° and 24,3±2,48 dB in the central 10° at 1 month P<0,001 24,2±3,26 dB in the central 2° and- 24,4±1,98 dB in the central 10° at 3 months P<0,001), and to 23,8±2,42 dB in the central 2° and 24,9 ± 2,06 dB in the central 10° (P<0,001). In all eyes, the retinal sensitivity improved after half-time RF-PDT at 6 months. The BCVA was significantly improved at 3 months (0,11±0,22 logMAR units, P<0,05) and at 6 months (0,10±0,17 logMAR units, P<0,05) after half-time RF-PDT than at baseline (0,16±0,20 logMAR units).OCT showed that the subretinal fluid (SRF) was completely resolved in 20 eyes (95%) at 1 month and 1 eye at 3 months. Six months after half-time RF-PDT, the SRF was resolved at all eyes. The CFT was significantly reduced from 289±77,8 ?m at baseline to 164±41,4 ?m at 1 month (P<0,001), 161±45,9 ?m at 3 months (P<0,001), and 172±35,7 ?m at 6 months (P<0,001). The CCT significantly improved from 405±105 ?m at baseline to 332±97,2 ?m at 1 month (P<0,001), 340±93,2 ?m at 3 month (P<0,001), and 333±108 ?m at 6 months (P<0,001). At 6 month, none of the patients had any systematic or local adverse events associated with the half-time RF-PDT.
Conclusions. Half-time RF-PDT results in a significant improvement of the central retinal sensitivity over 6 months in eyes with chronic CSC half-time RF-PDT is beneficial for resolving chronic CSC by 6 months.
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