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Optimal fluence rate of photodynamic therapy for chronic central serous chorioretinopathy
  1. Dong-Geun Park1,2,
  2. Seongyong Jeong1,2,
  3. Donghyoun Noh1,2,
  4. Min Sagong1,2
  1. 1 Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, South Korea
  2. 2 Yeungnam Eye Center, Yeungnam University Hospital, Daegu, South Korea
  1. Correspondence to Min Sagong, Department of Ophthalmology, Yeungnam University College of Medicine, #170 Hyunchungro, Nam-gu, Daegu 42415, South Korea; msagong{at}ynu.ac.kr

Abstract

Aims To investigate the lowest effective fluence rate of photodynamic therapy (PDT) for treating chronic central serous chorioretinopathy (CSC).

Methods Fifty-one eyes of 51 patients with chronic CSC were randomly treated with 30% (n=15), 40% (n=16) or 50% (n=17) of the standard-fluence rate of PDT and followed up for 12 months. The success rate, recurrence rate, mean best-corrected visual acuity (BCVA), central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), integrity of the outer retinal layer and complications were evaluated at baseline and at the follow-up periods after PDT.

Results The rate of complete subretinal fluid (SRF) resolution in the 30%-fluence, 40%-fluence and 50%-fluence groups was 60.0%, 81.2% and 100.0%, respectively, at 3 months (p=0.009), and 80.0%, 94.0% and 100.0%, respectively, at 12 months (p=0.06). The recurrence rate in the 50%-fluence group was lower than that in the 30%- and 40%-fluence groups at 12 months (30% vs 50%, 40% vs 50%; p=0.002, p=0.030, respectively (log-rank test)). The mean BCVA improved significantly 12 months after PDT only in the 40%- and 50%-fluence groups (p=0.005, p=0.003, respectively). Mean CFT and SFCT decreased significantly at 12 months in the three groups. The rate of complications did not differ significantly among the three groups.

Conclusions A 50%-fluence rate of PDT seems to be the most effective for treating chronic CSC, considering the low recurrence rate and high rate of complete SRF resolution, compared with other low-fluence PDT.

Trial registration number NCT01630863.

  • Retina
  • Macula
  • Choroid
  • Treatment Lasers

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Footnotes

  • D-GP and SJ contributed equally as the first authors.

  • Contributors MS had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: D-GP, SJ and MS. Data collection and statistical analysis: D-GP, SJ and DN. Drafting of the manuscript: D-GP and SJ. Critical revision of the manuscript for important intellectual content: DP, SJ and MS. Supervision: MS.

  • Funding MS was supported by the 2018 Yeungnam University research grant.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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