To compare the outcomes of half-dose verteporfin photodynamic therapy (vPDT) for central serous chorioretinopathy (CSCR) with or without subfoveal fibrin.
One hundred seventy-three cases of CSCR treated with half-dose vPDT between September 2008 and February 2018 were retrospectively reviewed and classified into two groups: CSCR with subfoveal fibrin (fibrin group) and without subfoveal fibrin (no-fibrin group). The changes in best-corrected visual acuity (BCVA) from baseline and in central macular thickness (CMT) were recorded at 1, 3, and 6 months after the treatment.
Forty-eight eyes were included in the fibrin group and 125 eyes in the no fibrin group. There were no statistical differences in the baseline characteristics including age, gender, duration of symptoms, and CMT between the groups. The baseline mean BCVA of the fibrin group was significantly worse than that of the no fibrin group (0.47 ± 0.32 versus 0.32 ± 0.31 in logMAR; p = 0.003). There was no statistically significant difference between the two groups in the improvement of BCVA at each follow-up point (1 month: p = 0.069; 3 months: p = 0.111; 6 months: p = 0.172, respectively) and in the reduction of CMT (1 month: p = 0.367; 3 months: p = 0.767; 6 months: p = 0.496, respectively). In the fibrin group, the rates of complete resolution of the subretinal fibrin at 1, 3, and 6 months after vPDT were 72.9%, 95.8%, 95.8%, respectively. The SRF resolution rate at 1, 3, and 6 months was 72.9%, 89.6% and 91.7% respectively in the fibrin group and was 62.4%, 83.2% and 84.0% in the no fibrin group. There was no significant difference of SRF resolution rate between the two groups at 1 month (p = 0.216), 3 months (p = 0.350), and 6 months (p = 0.228). No ocular adverse event was encountered in both groups.
Half-dose vPDT was effective and safe for CSCR patients with subfoveal fibrin.
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Gass JD. Pathogenesis of disciform detachment of the neuroepithelium. Am J Ophthalmol. 1967;63:1–139.
Saito M, Iida T, Kishi S. Ring-shaped subretinal fibrinous exudate in central serous chorioretinopathy. Jpn J Ophthalmol. 2005;49:516–9.
Iida T, Hagimura N, Sato T, Kishi S. Evaluation of central serous chorioretinopathy with optical coherence tomography. Am J Ophthalmol. 2000;129:16–20.
Kim HC, Cho WB, Chung H. Morphologic changes in acute central serous chorioretinopathy using spectral domain optical coherence tomography. Korean J Ophthalmol. 2012;26:347–54.
Yannuzzi NA, Mrejen S, Capuano V, Bhavsar KV, Querques G, Freund KB. A central hyporeflective subretinal lucency correlates with a region of focal leakage on fluorescein angiography in eyes with central serous chorioretinopathy. ophthalmic surg lasers imaging. Retina. 2015;46:832–6.
Venecia DG. Fluorescein angiographic smoke stack: case presentation at Verhoeff society Meeting, Washington, DC; April 24–25, 1982.
Nair U, Ganekal S, Soman M, Nair K. Correlation of spectral domain optical coherence tomography findings in acute central serous chorioretinopathy with visual acuity. Clin Ophthalmol. 2012;6:1949–54.
Fujimoto H, Gomi F, Wakabayashi T, Sawa M, Tsujikawa M, Tano Y. Morphologic changes in acute central serous chorioretinopathy evaluated by fourier-domain optical coherence tomography. Ophthalmology. 2008;115:1494–500.
Naseripour M, Falavarjani KG, Sedaghat A, Moghaddam AK, Nasserisina S, Alemzadeh SA. Half-dose photodynamic therapy for chronic central serous chorioretinopathy. J Ophthalmic Vis Res. 2016;11:66–9.
Tseng CC, Chen SN. Long-term efficacy of half-dose photodynamic therapy on chronic central serous chorioretinopathy. Br J Ophthalmol. 2015;99:1070–7.
Zhao M, Zhang F, Chen Y, Dai H, Qu J, Dong C, et al. A 50% vs 30% dose of verteporfin (photodynamic therapy) for acute central serous chorioretinopathy: one-year results of a randomized clinical trial. JAMA Ophthalmol. 2015;133:333–40.
Yannuzzi LA. Central serous chorioretinopathy: a personal perspective. Am J Ophthalmol. 2010;149:361–3.
Gass J Stereoscopic atlas of macular diseases: diagnosis and treatment, 4th ed. St Louis, MO: CV Mosby; 1987:56–7.
Ikui H. Histologic examination of central serous retinopathy. Nippon Ganka Kiyo. 1969;20:1035–41.
Schatz H, McDonald HR, Johnson RN, Chan CK, Irvine AR, Berger AR, et al. Subretinal fibrosis in central serous chorioretinopathy. Ophthalmology. 1995;102:1077–88.
Rezai KA, Eliott D. Optical coherence tomographic findings in pregnancy-associated central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2004;242:1014–6.
Shinojima A, Hirose T, Mori R, Kawamura A, Yuzawa M. Morphologic findings in acute central serous chorioretinopathy using spectral domain-optical coherence tomography with simultaneous angiography. Retina. 2010;30:193–202.
Hussain N, Baskar A, Ram LM, Das T. Optical coherence tomographic pattern of fluorescein angiographic leakage site in acute central serous chorioretinopathy. Clin Exp Ophthalmol. 2006;34:137–40.
Yu J, Jiang C, Xu G. Study of subretinal exudation and consequent changes in acute central serous chorioretinopathy by optical coherence tomography. Am J Ophthalmol. 2014;158:752–6.e752.
Ie D, Yannuzzi LA, Spaide RF, Rabb MF, Blair NP, Daily MJ. Subretinal exudative deposits in central serous chorioretinopathy. Br J Ophthalmol. 1993;77:349–53.
Besada E, Frauens BJ, Makhlouf R, Shechtman D. Comparative tomography of central serous 2 chorioretinopathy. New Front Ophthalmol. 2016;2:43–51.
Symeonidis C, Kaprinis K, Manthos K, Androudi S, Anastassilakis K, Dimitrakos SA. Central serous chorioretinopathy with subretinal deposition of fibrin-like material and its prompt response to ranibizumab injections. Case Rep Ophthalmol. 2011;2:59–64.
This work was supported by the National Natural Science Foundation of China Grant (81770943, 81470651); National key research and development program (2016YFC0904801, 2017YFC0111204); the Research Fund for Science and Technology Program of Beijing (Nos. Z171100002217081, Z161100000516037); Peking University People’s Hospital Scientific Research Development Funds (RDY2017-31). The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.
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Liang, Z., Qu, J., Huang, L. et al. Comparison of the outcomes of photodynamic therapy for central serous chorioretinopathy with or without subfoveal fibrin. Eye (2020). https://doi.org/10.1038/s41433-020-0858-4