A randomized pilot study of low-fluence photodynamic therapy versus intravitreal ranibizumab for chronic central serous chorioretinopathy

So Hyun Bae; Jang Won Heo; Cinoo Kim; Tae Wan Kim; Joo Yong Lee; Su Jeong Song; Tae Kwann Park; Sang Woong Moon; Hum Chung

doi:10.1016/j.ajo.2011.04.008

A randomized pilot study of low-fluence photodynamic therapy versus intravitreal ranibizumab for chronic central serous chorioretinopathy

Am J Ophthalmol. 2011 Nov;152(5):784-92.e2. doi: 10.1016/j.ajo.2011.04.008. Epub 2011 Jul 13.

Authors

So Hyun Bae¹, Jang Won Heo, Cinoo Kim, Tae Wan Kim, Joo Yong Lee, Su Jeong Song, Tae Kwann Park, Sang Woong Moon, Hum Chung

Affiliation

¹ Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea.

PMID: 21742303
DOI: 10.1016/j.ajo.2011.04.008

Abstract

Purpose: To report 6-month outcomes of a prospective, randomized study comparing the efficacy and safety between low-fluence photodynamic therapy (PDT) and intravitreal injections of ranibizumab in the treatment of chronic central serous chorioretinopathy.

Design: Prospective, randomized, single-center pilot study.

Methods: Sixteen eyes with chronic central serous chorioretinopathy were randomized to receive either low-fluence PDT or intravitreal injections of ranibizumab: 8 eyes in the low-fluence PDT group and 8 in the ranibizumab group. Rescue treatment was considered if subretinal fluid was sustained after completion of primary treatment: low-fluence PDT for the ranibizumab group and ranibizumab injection for the low-fluence PDT group. Main outcome measures were excess foveal thickness, resolution of subretinal fluid, choroidal perfusion on indocyanine green angiography, and best-corrected visual acuity.

Results: At 3 months, the mean excess foveal thickness was reduced from 74.1 ± 56.0 μm to -35.4 ± 44.5 μm in the low-fluence PDT group (P = .017) and from 26.3 ± 50.6 μm to -23.1 ± 56.5 μm in the ranibizumab group (P = .058). After a single session of PDT, 6 eyes (75%) in the low-fluence PDT group achieved complete resolution of subretinal fluid and reduction of choroidal hyperpermeability, whereas 2 (25%) eyes in the ranibizumab group achieved this after consecutive ranibizumab injections. Four eyes (50%) in the ranibizumab group underwent additional low-fluence PDT and accomplished complete resolution. At 3 months, significant improvement of best-corrected visual acuity was not demonstrated in the low-fluence PDT group (P = .075), whereas it was observed in the ranibizumab group (P = .012). However, the tendency toward improvement of best-corrected visual acuity was not maintained.

Conclusions: In terms of anatomic outcomes, the effect of ranibizumab injections was not promising compared with that of low-fluence PDT.

Trial registration: ClinicalTrials.gov NCT01325181.

Publication types

Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Antibodies, Monoclonal, Humanized / administration & dosage
Antibodies, Monoclonal, Humanized / therapeutic use*
Central Serous Chorioretinopathy / diagnosis
Central Serous Chorioretinopathy / drug therapy*
Central Serous Chorioretinopathy / physiopathology
Chronic Disease
Coloring Agents
Female
Fluorescein Angiography
Humans
Indocyanine Green
Intravitreal Injections
Male
Middle Aged
Photochemotherapy*
Photosensitizing Agents / therapeutic use
Pilot Projects
Porphyrins / therapeutic use
Prospective Studies
Ranibizumab
Tomography, Optical Coherence
Treatment Outcome
Verteporfin
Visual Acuity / physiology

Substances

Antibodies, Monoclonal, Humanized
Coloring Agents
Photosensitizing Agents
Porphyrins
Verteporfin
Indocyanine Green
Ranibizumab

Associated data

ClinicalTrials.gov/NCT01325181