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Long-term follow-up of half-fluence photodynamic therapy in acute central serous chorioretinopathy

Langzeitergebnisse nach photodynamischer Therapie mit reduzierter Lichtdosis bei akuter Chorioretinopathia centralis serosa

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Summary

Background

To evaluate the long-term results of indocyanine green angiography(ICGA)-guided verteporfin (Visudyne®, Novartis, Basel, Switzerland) photodynamic therapy (PDT) with half-fluence rate in the treatment of acute symptomatic central serous chorioretinopathy (CSC).

Material and methods

A retrospective review was performed of 12 patients with acute symptomatic CSC verified by spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA), treated with ICGA-guided verteporfin (6 mg/m2)-PDT with half-fluence rate (25 J/cm2). The vision-related quality of life (VR QOL) 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) was completed by all patients and 82 controls.

Results

Best corrected visual acuity (BCVA) at baseline was 77.5 (±10; n = 12) according to the Early Treatment Diabetic Retinopathy Study (EDTRS) letter score and changed to 89 letters (±9.9; p = 0.0003) at long-term follow-up (83.8 ± 4.8 months after PDT). Baseline contrast sensitivity (CS) was 29.5 ± 4.5 Pelli–Robson letters and increased to 34.5 ± 4.5 letters at long term (p < 0.0006). Baseline central foveal thickness (CFT) was 419 μm and decreased to 242 µm at long term (p < 0.0001). The long-term vision-related quality of life of patients was similar to that of controls.

Conclusion

ICGA-guided half-fluence PDT with verteporfin results in excellent long-term visual improvement in BCVA and CS, a significant reduction of CFT, and high levels of VR QOL.

Zusammenfassung

Hintergrund

Langzeitergebnisse der mittels Indozyaningrünangiographie (ICGA) gesteuerten photodynamischen Therapie (PDT) mit reduzierter Lichtdosis und Gabe von Verteporfin (Visudyne®, Novartis, Basel, Schweiz) zur Behandlung der akuten symptomatischen Chorioretinopathia centralis serosa (CSC) werden präsentiert.

Material und Methode

Retrospektiv wurden Daten von 12 Patienten ausgewertet, bei denen aufgrund einer akuten symptomatischen CSC, die mittels Fluoreszeinangiographie (FA) und ICGA diagnostiziert worden war, eine ICGA-gesteuerte PDT unter Gabe von Verteporfin (6 mg/m2) mit reduzierter Lichtdosis (25 J/cm2) erfolgte. Die Ergebnisse des 25-Item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) wurden ebenfalls ausgewertet und mit den Ergebnissen von 82 gesunden Kontrollen verglichen.

Ergebnisse

Die bestkorrigierte Sehschärfe (BCVA) vor PDT betrug 77,5 (±10; n = 12) Buchstaben auf der Tafel gemäß Early Treatment Diabetic Retinopathy Study (ETDRS) und steigerte sich auf 89 Buchstaben (±9,9; p = 0,0003) am Ende der Follow-up-Periode (83,8 ± 4,8 Monate nach PDT). Für die Kontrastsensitivität (CS) betrug der Ausgangswert 29,5 ± 4,5 Pelli-Robson-Buchstaben, er stieg auf 34,5 ± 4,5 Buchstaben am Ende der Langzeitnachbeobachtung(p < 0,0006). Vor PDT betrug die zentrale foveale Dicke (CFT) 419 μm und am Ende der Follow-up-Periode 242 µm (p < 0,0001). Die auf den Langzeitvisus bezogene Lebensqualität war auf einem vergleichbaren Niveau wie bei der gesunden Kontrollgruppe.

Schlussfolgerung

Die ICGA-gesteuerte Verteporfin-PDT mit reduzierter Lichtdosis erzielt hervorragende Langzeitergebnisse hinsichtlich BCVA, CS und Reduktion der CFT sowie gute Resultate bei der visusbezogenen Lebensqualität.

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Authors and Affiliations

  1. Karl Landsteiner Institute for Retinal Research and Imaging, Vienna, Austria

    Eva Smretschnig MD, Stefan Hagen MD, Ilse Krebs MD, Susanne Binder MD & Siamak Ansari-Shahrezaei MD

  2. Department of Ophthalmology, Rudolf Foundation Hospital, Juchgasse 25, 1030, Vienna, Austria

    Eva Smretschnig MD, Stefan Hagen MD, Ilse Krebs MD, Susanne Binder MD & Siamak Ansari-Shahrezaei MD

  3. Department of Ophthalmology, Medical University of Graz, Graz, Austria

    Siamak Ansari-Shahrezaei MD

  4. Retina Center Vienna, Vienna, Austria

    Susanne Binder MD & Siamak Ansari-Shahrezaei MD

  5. Institute for Medical Statistics, Medical University of Vienna, Vienna, Austria

    Jutta Gamper BSc

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  1. Eva Smretschnig MD
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Corresponding author

Correspondence to Eva Smretschnig MD.

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Conflict of interest

E. Smretschnig, S. Hagen, J. Gamper, I. Krebs, S. Binder, and S. Ansari-Shahrezaei declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Authors’ contributions

Design of the study (E. Smretschnig, S. Ansari-Shahrezaei), conduct of the study (E. Smretschnig, S. Hagen, J. Gamper, I. Krebs, S. Binder, S. Ansari-Shahrezaei), data collection and management (E. Smretschnig, S. Hagen), analysis (E. Smretschnig, J. Gamper, S. Ansari-Shahrezaei), interpretation (E. Smretschnig, S. Hagen, I. Krebs, S. Binder, S. Ansari-Shahrezaei), preparation (E.S, S. Ansari-Shahrezaei), review and final approval (E. Smretschnig, S. Hagen, I. Krebs, J. Gamper, S. Binder, S. Ansari-Shahrezaei)

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Smretschnig, E., Hagen, S., Gamper, J. et al. Long-term follow-up of half-fluence photodynamic therapy in acute central serous chorioretinopathy. Spektrum Augenheilkd. 32, 215–222 (2018). https://doi.org/10.1007/s00717-018-0412-y

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  • DOI: https://doi.org/10.1007/s00717-018-0412-y

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