Comprehensive evaluation of intravitreal conbercept versus half-dose photodynamic therapy for chronic central serous chorioretinopathy

AIM: To compare the safety and efficacy of conbercept intravitreal injection and half-dose photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC). METHODS: This study was retrospective. Thirty-seven patients (37 eyes) with chronic CSC received conbercept injections while 57 patients (57 eyes) were treated with half-dose PDT. All subjects were followed in 6mo. Outcome measures included change in best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and resolution of subretinal fluid (SRF). RESULTS: There was no adverse event observed in either treatment group. At the 6-month follow-up, 26 eyes (70.3%) in the conbercept group and 54 eyes (94.7%) in the half-dose PDT group (P<0.05) reached full resolution of SRF. The mean logarithm of the minimum angle of resolution (logMAR) BCVA significantly improved (P<0.001) in both treatment groups with better outcome at early phase in the half-dose PDT group (2wk, 1, and 2mo, P<0.05). All subjects experienced significant CMT improvement (P<0.001) with no statistical difference between the two groups (P>0.05). The SFCT also improved in all subjects (P<0.001) with better outcome in the half-dose PDT group (P<0.05). CONCLUSION: Both intravitreal conbercept and half-dose PDT are safe to use in treating chronic CSC. By 6mo, both treatment groups are efficacious in improving BCVA, reducing CMT and SFCT, and resolving SRF in eyes with chronic CSC. Half-dose PDT may show better outcome at initial phase of treatment in chronic CSC. Longer follow-up period is necessary to study for long-term effect and safety.

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One-year results of half-dose versus one-third-dose photodynamic therapy in chronic or recurrent central serous chorioretinopathy

BMC Ophthalmology ◽

10.1186/s12886-020-01796-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jirarattanasopa Pichai ◽

Banchasakjaroen Vanchalerm ◽

Ratanasukon Mansing

Keyword(s):

Photodynamic Therapy ◽

Recurrence Rate ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Corrected Visual Acuity ◽

Half Dose ◽

One Year ◽

The One ◽

Different Doses

Abstract Background Central serous chorioretinopathy (CSC) is characterized by an accumulation of subretinal fluid (SRF) in the macula. It is usually treated by laser photocoagulation or photodynamic therapy (PDT) with consisting of different doses and power. This study aimed to compare the efficacy of half-dose PDT and one-third-dose PDT in chronic or recurrent CSC. Methods A retrospective review of patients with chronic or recurrent CSC who were treated with either a half-dose or one-third-dose PDT, and had follow up 12 months afterwards. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and resolution of subretinal fluid (SRF) at baseline as well as 1, 3, 6 and 12 months post-PDT were assessed. Results Forty-six eyes and 20 eyes received half-dose and one-third-dose PDT, respectively. The study showed efficacy of the one-third-dose PDT compared with half-dose PDT in BCVA improvement (0.10±0.04 logMAR for one-third-dose versus 0.17±0.04, for half-dose, P=0.148) and CRT improvement (125.6±24.6 μm for one-third-dose versus 139.1±16.54, for half-dose, P=0.933) at 12 months. The SRF recurrence rate was significantly higher in the one-third-dose PDT group compared with the half-dose PDT group (40.0% versus 15.2%, P=0.027) at 12-months. Conclusion At 12 months, the one-third-dose PDT was effective in terms of BCVA and CRT improvement, when compared with half-dose PDT. However, this study showed that one-third-dose PDT had a higher recurrence rate of SRF.

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Assessment of choriocapillary blood flow changes in response to half-dose photodynamic therapy in chronic central serous chorioretinopathy using optical coherence tomography angiography

10.21203/rs.2.18778/v6 ◽

2020 ◽

Author(s):

Juejun Liu ◽

Changzheng Chen ◽

Lu Li ◽

Yishuang Xu ◽

Zuohuizi Yi ◽

...

Keyword(s):

Blood Flow ◽

Optical Coherence Tomography ◽

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Chronic Central Serous Chorioretinopathy ◽

Half Dose ◽

Flow Changes

Abstract Background: Optical coherence tomography angiography (OCTA) is a newly developed imaging quantitative technique for analysis of choriocapillaris (CC) flow changes, thereby exploring the pathological mechanism of chronic central serous chorioretinopathy (CCSC) and the therapeutic effects of photodynamic therapy (PDT). In this study, we sought to quantify the blood flow changes in CC of CCSC patients receiving half-dose PDT using OCTA.Methods: A total of 28 affected eyes and 24 unaffected eyes of 26 CCSC patients receiving half-dose PDT, and 40 eyes of 20 healthy gender- and age-matched subjects were retrospectively enrolled in this study. The proportion of total areas of flow signal voids (FSV, %) in CC level of OCTA was assessed in both eyes of the CCSC patients at baseline and repeated in multiple sections at 1-week, 1-month, 3-month and 6-month intervals after PDT. In addition, the CC patterns in response to PDT at early stage and the subsequent morphologic changes were qualitatively documented using OCTA.Results: For affected eyes, FSV at 6-m follow-up was significantly lower than that at 1-m follow-up (p=0.036). When compared to normal control eyes, FSV in affected eyes was significantly higher at 1-m, 3-m and 6-m follow-up (p<0.05 for all), and FSV in unaffected eyes was significantly higher at baseline, 1-w, 1-m and 3-m follow-up (p<0.05 for all). Three CC patterns of early response to PDT were identified, including signs of recovery with more even flow signals, transient appearance of worse ischemia and secondary neovascularization within CC level.Conclusion: Abnormal CC flow attenuation remains in completely resolved eyes of CCSC patients treated with half-dose PDT.

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Assessment of choriocapillary blood flow changes in response to half-dose photodynamic therapy in chronic central serous chorioretinopathy using optical coherence tomography angiography

BMC Ophthalmology ◽

10.1186/s12886-020-01674-9 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Juejun Liu ◽

Changzheng Chen ◽

Lu Li ◽

Yishuang Xu ◽

Zuohuizi Yi ◽

...

Keyword(s):

Blood Flow ◽

Optical Coherence Tomography ◽

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Chronic Central Serous Chorioretinopathy ◽

Half Dose ◽

Flow Changes

Abstract Background Optical coherence tomography angiography (OCTA) is a newly developed imaging quantitative technique for analysis of choriocapillaris (CC) flow changes, thereby exploring the pathological mechanism of chronic central serous chorioretinopathy (CCSC) and the therapeutic effects of photodynamic therapy (PDT). In this study, we sought to quantify the blood flow changes in CC of CCSC patients receiving half-dose PDT using OCTA. Methods A total of 28 affected eyes and 24 unaffected eyes of 26 CCSC patients receiving half-dose PDT, and 40 eyes of 20 healthy gender- and age-matched subjects were retrospectively enrolled in this study. The proportion of total areas of flow signal voids (FSV, %) in CC level of OCTA was assessed in both eyes of the CCSC patients at baseline and repeated in multiple sections at 1-week, 1-month, 3-month and 6-month intervals after PDT. In addition, the CC patterns in response to PDT at early stage and the subsequent morphologic changes were qualitatively documented using OCTA. Results For affected eyes, FSV at 6-m follow-up was significantly lower than that at 1-m follow-up (p = 0.036). When compared to normal control eyes, FSV in affected eyes was significantly higher at 1-m, 3-m and 6-m follow-up (p < 0.05 for all), and FSV in unaffected eyes was significantly higher at baseline, 1-w, 1-m and 3-m follow-up (p < 0.05 for all). Three CC patterns of early response to PDT were identified, including signs of recovery with more even flow signals, transient appearance of worse ischemia and secondary neovascularization within CC level. Conclusion Abnormal CC flow attenuation remains in completely resolved eyes of CCSC patients treated with half-dose PDT.

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Fundus Autofluorescence after Half-Dose Photodynamic Therapy for Chronic Central Serous Chorioretinopathy

Biomedicine Hub ◽

10.1159/000512662 ◽

2020 ◽

pp. 1-5

Author(s):

Kyoko Fujita ◽

Yutaka Imamura ◽

Kei Shinoda ◽

Soiti Matsumoto ◽

Mitsuko Yuzawa

Keyword(s):

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Choroidal Thickness ◽

Fundus Autofluorescence ◽

Serous Retinal Detachment ◽

Enhanced Depth Imaging ◽

Chronic Central Serous Chorioretinopathy ◽

Long Term Effect ◽

Half Dose

Introduction: To evaluate the fundus autofluorescence (FAF) images 1 year after half-dose photodynamic therapy (hdPDT) for chronic central serous chorioretinopathy (CSC). Methods: Forty-six eyes of 46 consecutive patients with chronic CSC underwent hdPDT. Short wavelength-elicited FAF images and enhanced depth imaging optical coherence tomographic (EDI-OCT) images were recorded before and at 1, 3, 6, 9, and 12 months after the hdPDT. The FAF images at 1 month were compared to those at 12 months after the hdPDT. Results: The serous retinal detachment (SRD) was resolved in all eyes. The best-corrected visual acuity (BCVA) improved significantly from 0.13 ± 0.28 logarithm of minimum angle of resolution (logMAR) units before to 0.01 ± 0.17 logMAR units at 12 months after the hdPDT (p = 0.001; paired t test). The mean choroidal thickness decreased significantly from 365.4 ± 103.0 µm to 284.3 ± 92.5 µm at 12 months (p < 0.001). Abnormal FAF images were present within the irradiated area in all the eyes before the hdPDT. In 5 of 46 eyes, identifiable changes of the FAF images were observed 12 months after hdPDT. None of the eyes had the confluent hypo-FAF type during the follow-up period. Univariate analyses showed that the choroidal thickness before hdPDT correlated significantly with hypo-FAF enlargement (p = 0.005). However, multivariate analyses showed that the association was not significant (p = 0.06). Conclusions: The progression of the RPE damages occurred in approximately one-tenth of the eyes that underwent hdPDT for chronic CSC. The long-term effect of progression of hypo-FAF on visual functions remains to be determined.

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The Efficacy of Intravitreal Conbercept for Chronic Central Serous Chorioretinopathy

Journal of Ophthalmology ◽

10.1155/2019/7409426 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Jianbo Mao ◽

Caiyun Zhang ◽

Chenyi Liu ◽

Lijun Shen ◽

Jimeng Lao ◽

...

Keyword(s):

Repeated Measures ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Short Term ◽

Chronic Central Serous Chorioretinopathy ◽

Full Resolution ◽

Repeated Measures Analysis ◽

Retrospective Clinical Study ◽

The Mean

Purpose. To evaluate the efficacy and safety of conbercept for patients with chronic central serous chorioretinopathy (CSC). Methods. A retrospective clinical study. Thirty-one patients (35 eyes) with chronic CSC were given intravitreal injections of conbercept and followed up for at least 6 months. Observed indicators included best-corrected visual acuity (BCVA), central macular thickness (CMT), and resolution of subretinal fluid (SRF). Serial changes in BCVA and CMT were analyzed by using repeated measures analysis of variance. Results. During the 6-month follow-up, the mean number of injections required and performed was 1.77 ± 0.60. The logMAR BCVA was 0.48 ± 0.26 at the baseline, 0.34 ± 0.26, 0.30 ± 0.26, 0.27 ± 0.26, 0.24 ± 0.26, and 0.23 ± 0.26 at 2-week and 1-, 2-, 3-, and 6-month follow-ups, respectively (F = 27.173, P<0.05). CMT was 313.74 ± 144.51 μm at the baseline and decreased to 263.49 ± 120.44 μm, 225.91 ± 91.98 μm, 195.77 ± 66.69 μm, 189.74 ± 65.41 μm, and 199.49 ± 81.50 μm at 2-week and 1-, 2-, 3-, and 6-month follow-ups, respectively (F = 18.093, P<0.05). Full resolution of SRF was achieved in 8 (22.9%) eyes at 1 month, 16 (45.7%) eyes at 2 months, 22 (62.9%) eyes at 3 months, and 27 (77.1%) eyes at 6 months after the initial treatment of anti-VEGF injection. No severe adverse event was noted relevant to the therapy. Conclusions. Intravitreal injection of conbercept may effectively reduce the CMT and improve the BCVA in chronic CSC in a short term of 6 months.

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Anatomical Retinal Changes after Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

Journal of Ophthalmology ◽

10.1155/2018/4081874 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

María Pilar Ruiz-del-Tiempo ◽

Pilar Calvo ◽

Antonio Ferreras ◽

Jesús Leciñena ◽

Luis Pablo ◽

...

Keyword(s):

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Retinal Thickness ◽

Outer Nuclear Layer ◽

Subretinal Fluid ◽

Chronic Central Serous Chorioretinopathy ◽

One Year ◽

Mean Time ◽

Sd Oct

Purpose. To evaluate anatomical retinal changes measured by spectral-domain optical coherence tomography (SD-OCT), after applying photodynamic therapy (PDT) for treatment of chronic central serous chorioretinopathy (CSC). Methods. A retrospective analysis was conducted on 43 patients (48 eyes) with chronic CSC treated with PDT. Visual acuity (VA), central retinal thickness (CRT), outer nuclear layer (ONL) thickness, subretinal fluid (SRF), and photoreceptor ellipsoid zone (EZ) measured by SD-OCT were collected at baseline and at 3, 6, and 12 months after PDT. Differences between normally distributed variables were calculated by a paired-sample t-test; p<0.05 was considered statistically significant. Results. Mean age was 50 ± 9.8 years. Mean time from diagnosis to PDT was 12.5 months. Baseline VA was 0.51 ± 0.24 and significantly improved (p<0.001) to 0.74 ± 0.26 one year after PDT. CRT and SRF significantly decreased (p<0.001) at 3, 6, and 12 months after treatment. ONL thickness and EZ did not significantly change at any point during follow-up. Conclusions. Not significant changes were found in the ONL or EZ 12 months after PDT.

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Assessment of choriocapillary blood flow changes in response to half-dose PDT in chronic central serous chorioretinopathy using OCTA

10.21203/rs.2.18778/v2 ◽

2020 ◽

Author(s):

Juejun Liu ◽

Changzheng Chen ◽

Lu Li ◽

Yishuang Xu ◽

Zuohuizi Yi ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Optical Coherence Tomography Angiography ◽

Early Stage ◽

Optical Coherence ◽

Chronic Central Serous Chorioretinopathy ◽

Half Dose ◽

Flow Changes

Abstract Background: To quantify flow changes in choriocapillaris (CC) in patients with chronic central serous chorioretinopathy (CCSC) in the treatment of half-dose photodynamic therapy (PDT) using optical coherence tomography angiography (OCTA) . Methods : A total of 28 affected eyes and 24 unaffected eyes of 26 CCSC patients receiving half-dose PDT, and 40 eyes of 20 healthy gender- and age-matched subjects were retrospectively enrolled. Proportion of total areas of flow signal voids ( FSV , %) in CC level of OCTA were mainly assessments in both eyes of the CCSC patients at baseline and repeated in multiple sections at 1-week, 1-month, 3-month and 6-month intervals after PDT. In addition , CC patterns in response to PDT at early stage and their subsequent morphologic changes were qualitatively documented using OCTA. Results: For affected eyes, significant decrease in FSV was found at 6-m follow-up than 1-m follow-up (p=0.036). Comparing to normal control eyes, FSV in affected eyes was significantly higher at 1-m, 3-m and 6-m follow-up (p<0.05 for all), while FSV in unaffected eyes was significantly higher at baseline, 1-w, 1-m and 3-m follow-up (p<0.05 for all). Three CC patterns of early response to PDT can be identified, including signs of recovery with more even flow signals, transient appearance of worsen ischemia and secondary neovascularization within CC level. Conclusion: Abnormal CC flow attenuation remained in completely resolved eyes of CCSC patients treated with half-dose PDT. Key Words: Chronic; Central Serous Chorioretinopathy; Optical Coherence Tomography Angiography; Photodynamic Therapy

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Assessment of choriocapillary blood flow changes in response to half-dose PDT in chronic central serous chorioretinopathy using OCTA

10.21203/rs.2.18778/v1 ◽

2019 ◽

Author(s):

Juejun Liu ◽

Changzheng Chen ◽

Lu Li ◽

Yishuang Xu ◽

Zuohuizi Yi ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Optical Coherence Tomography Angiography ◽

Early Stage ◽

Optical Coherence ◽

Chronic Central Serous Chorioretinopathy ◽

Half Dose ◽

Flow Changes

Abstract Background: To quantify flow changes in choriocapillaris (CC) in patients with chronic central serous chorioretinopathy (CCSC) in the treatment of half-dose photodynamic therapy (PDT) using optical coherence tomography angiography (OCTA).Methods: A total of 28 affected eyes and 24 unaffected eyes of 26 CCSC patients receiving half-dose PDT, and 40 eyes of 20 healthy gender- and age-matched subjects were retrospectively enrolled. Proportion of total areas of flow signal voids (FSV, %) in CC level of OCTA were mainly assessments in both eyes of the CCSC patients at baseline and repeated in multiple sections at 1-week, 1-month, 3-month and 6-month intervals after PDT. In addition, CC patterns in response to PDT at early stage and their subsequent morphologic changes were qualitatively documented using OCTA. Results: For affected eyes, significant decrease in FSV was found at 6-m follow-up than 1-m follow-up (p=0.036). Comparing to normal control eyes, FSV in affected eyes was significantly higher at 1-m, 3-m and 6-m follow-up (p<0.05 for all), while FSV in unaffected eyes was significantly higher at baseline, 1-w, 1-m and 3-m follow-up (p<0.05 for all). Three CC patterns of early response to PDT can be identified, including signs of recovery with more even flow signals, transient appearance of worsen ischemia and secondary neovascularization within CC level. Conclusion: Abnormal CC flow attenuation remained in completely resolved eyes of CCSC patients treated with half-dose PDT. Key Words: Chronic; Central Serous Chorioretinopathy; Optical Coherence Tomography Angiography; Photodynamic Therapy

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One-year results of half-dose versus one-third-dose photodynamic therapy in chronic or recurrent central serous chorioretinopathy

10.21203/rs.3.rs-38736/v3 ◽

2021 ◽

Author(s):

Pichai Jirarattanasopa ◽

Banchasakjaroen Vanchalerm ◽

Ratanasukon Mansing

Keyword(s):

Photodynamic Therapy ◽

Recurrence Rate ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Corrected Visual Acuity ◽

Half Dose ◽

One Year ◽

The One ◽

Different Doses

Abstract Background: Central serous chorioretinopathy (CSC) is characterized by an accumulation of subretinal fluid (SRF) in the macula. It is usually treated by laser photocoagulation or photodynamic therapy (PDT) with consisting of different doses and power. This study aimed to compare the efficacy of half-dose PDT and one-third-dose PDT in chronic or recurrent CSC.Methods: A retrospective review of patients with chronic or recurrent CSC who were treated with either a half-dose or one-third-dose PDT, and had follow up 12 months afterwards. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and resolution of subretinal fluid (SRF) at baseline as well as 1, 3, 6 and 12 months post-PDT were assessed.Results: Forty-six eyes and 20 eyes received half-dose and one-third-dose PDT, respectively. The study showed efficacy of the one-third-dose PDT compared with half-dose PDT in BCVA improvement (0.10±0.04 logMAR for one-third-dose versus 0.17±0.04, for half-dose, P=0.148) and CRT improvement (125.6±24.6 µm for one-third-dose versus 139.1±16.54, for half-dose, P=0.933) at 12 months. The SRF recurrence rate was significantly higher in the one-third-dose PDT group compared with the half-dose PDT group (40.0% versus 15.2%, P=0.027) at 12-months.Conclusion: At 12 months, the one-third-dose PDT was effective in terms of BCVA and CRT improvement, when compared with half-dose PDT. However, this study showed that one-third-dose PDT had a higher recurrence rate of SRF.

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