Comparison of the outcomes of photodynamic therapy for central serous chorioretinopathy with or without subfoveal fibrin

Abstract

Background

To compare the outcomes of half-dose verteporfin photodynamic therapy (vPDT) for central serous chorioretinopathy (CSCR) with or without subfoveal fibrin.

Methods

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.

Results

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.

Conclusion

Half-dose vPDT was effective and safe for CSCR patients with subfoveal fibrin.

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Fig. 1: Examples of the fibrin group and the no fibrin group in this study.
Fig. 2: “String-like” pattern and hyporeflective lucency surrounded by fibrin in the fibrin group.
Fig. 3: Serial changes of BCVA and CMT from baseline at each follow-up visit in the two groups.
Fig. 4: A representative case of central serous chorioretinopathy with subfoveal fibrin resolution after half-dose vPDT.

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Funding

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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Correspondence to Mingwei Zhao.

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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

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