Reduced-fluence photodynamic therapy (rf-PDT) appears to maintain visual acuity (VA) and limit the remission of serous retinal detachment (SRD) in patients with chronic central serous chorioretinopathy (cCSC), according to a study published in Ophthalmology Science.

Researchers conducted a study to evaluate the long-term effectiveness and safety of rf-PDT for patients with cCSC compared with untreated controls. The primary outcome measure was the improvement of best corrected visual acuity (BCVA) at 2-year follow-up.

The team enrolled 155 patients with active serous retinal detachment (SRD) from May 2007 to June 2017 in this retroscopic analysis. They included patients with records of  comprehensive eye exams that included BCVA measurement, biomicroscopy, optical coherence tomography (OCT), and dilated fundus imaging. The investigators assessed 18 baseline characteristics with inverse probability of treatment weighting (IPTW) to compare patients who underwent rf-PDT (n=74) with controls (n=81).


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The researchers found that the rf-PDT group had a higher VA maintenance rate compared with the control group (93.6% vs 70.9%, P <.001 at 12 months; 85.7% vs 69.8%, P =.019 at 24 months). They also noted that although VA improvement was greater among individuals receiving rf-PDT, these values failed to achieve statistical significance when compared with controls (-0.06 vs -0.008, P =.07 at 12 months; -0.06 vs -0.03, P =.32 at 24 months).

The rf-PDT group also demonstrated a higher rate of complete SRD remission (HR: 5.05, 95% CI, 3.24-7.89, P <.001) compared with controls, with more than 80% of individuals in the former group achieving complete remission at 60 days from treatment compared with only 20% in the latter group.

“This study revealed that rf-PDT was associated with a significantly higher BCVA maintenance rate, higher proportion of complete SRD remission, and a trend toward better visual improvement in patients with cCSC,” according to the researchers.

Limitations of the study include the exclusive use of VA and complete SRD remission as outcome measures, small sample size, and its retroscopic nature.

Reference

Aisu N, Miyake M, Hosoda Y, et al. Effectiveness of reduced-fluence photodynamic therapy for chronic central serous chorioretinopathy: a propensity score analysis. Ophthalmol Sci. Published online April 6, 2022. doi:10.1016/j.xops.2022.100152