Functional retinal changes measured by microperimetry in standard-fluence vs low-fluence photodynamic therapy in chronic central serous chorioretinopathy

Am J Ophthalmol. 2011 Jun;151(6):953-960.e2. doi: 10.1016/j.ajo.2010.12.007. Epub 2011 Mar 31.

Abstract

Purpose: To evaluate the effect of low-fluence photodynamic therapy (PDT) on central retinal sensitivity and fixation stability as compared with standard-fluence PDT for treating chronic central serous chorioretinopathy (CSC).

Design: Prospective longitudinal follow-up of patients enrolled in a nonrandomized clinical trial of standard-fluence vs low-fluence PDT in chronic CSC.

Methods: Forty-two eyes (42 patients) with chronic CSC were enrolled; 19 eyes received indocyanine green angiography-guided standard-fluence PDT (50 J/cm(2)) and 23 received indocyanine green angiography-guided low-fluence PDT (25 J/cm(2)). Retinal sensitivity in the central 12 degrees and fixation stability were evaluated by MP-1 microperimeter at baseline and at 3 and 12 months after PDT.

Results: Mean central retinal sensitivity improved significantly at all time points (at 12 months vs baseline P < .01, Tukey-Kramer test), in the standard-fluence group from 11.9 to 14.4 at 12 months, and in the low-fluence-group from 11.8 to 16.3, with a significant difference between the 2 groups (P = .04, t test). Fixation stability did not change in either group (not significant, analysis of variance). At 12 months' follow-up the retinal sensitivity significantly correlated with best-corrected visual acuity in both groups (standard-fluence, r = -0.52, P = .02; low-fluence, r = -0.54, P = .01).

Conclusions: The study shows a significant improvement in macular sensitivity after PDT in eyes with chronic CSC, with greater efficacy in low-fluence-treated eyes. Microperimetry data suggest that low-fluence PDT may be a good treatment option in patients with chronic CSC.

Publication types

  • Comparative Study
  • Controlled Clinical Trial
  • Multicenter Study

MeSH terms

  • Central Serous Chorioretinopathy / diagnosis
  • Central Serous Chorioretinopathy / drug therapy*
  • Central Serous Chorioretinopathy / physiopathology
  • Chronic Disease
  • Female
  • Fixation, Ocular / physiology
  • Fluorescein Angiography
  • Follow-Up Studies
  • Humans
  • Indocyanine Green
  • Male
  • Middle Aged
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use
  • Porphyrins / therapeutic use
  • Prospective Studies
  • Retina / physiology*
  • Sensitivity and Specificity
  • Tomography, Optical Coherence
  • Verteporfin
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields / physiology*

Substances

  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin
  • Indocyanine Green