Safety and Efficacy of Half-dose and Half-fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy: A Systematic Review and Meta-analysis

Michele Zaman; Andrew Mihalache; Ryan S Huang; Nirmay Shah; Marko M Popovic; Peter J Kertes; Rajeev H Muni; Radha P Kohly

doi:10.1016/j.ajo.2024.11.014

Safety and Efficacy of Half-dose and Half-fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy: A Systematic Review and Meta-analysis

Am J Ophthalmol. 2024 Nov 25:271:233-242. doi: 10.1016/j.ajo.2024.11.014. Online ahead of print.

Authors

Michele Zaman¹, Andrew Mihalache², Ryan S Huang², Nirmay Shah¹, Marko M Popovic³, Peter J Kertes⁴, Rajeev H Muni⁴, Radha P Kohly⁵

Affiliations

¹ From the Department of Medicine, School of Medicine (M.Z. and N.S.), Queen's University, Kingston, Ontario, Canada.
² Temerty Faculty of Medicine (A.M. and R.S.H.), University of Toronto, Toronto, Canada.
³ Department of Ophthalmology and Vision Sciences (M.M.P. and R.P.K.), University of Toronto, Toronto, Canada.
⁴ John and Liz Tory Eye Centre (P.J.K., R.H.M., and R.P.K.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Kensington Eye Institute (P.J.K. and R.H.M.), Toronto, Canada; Department of Ophthalmology (P.J.K. and R.H.M.), Unity Health Toronto, Toronto, Canada.
⁵ Department of Ophthalmology and Vision Sciences (M.M.P. and R.P.K.), University of Toronto, Toronto, Canada; John and Liz Tory Eye Centre (P.J.K., R.H.M., and R.P.K.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: [email protected].

PMID: 39603314
DOI: 10.1016/j.ajo.2024.11.014

Abstract

Purpose: To investigate the comparative efficacy and safety of half-dose photodynamic therapy (PDT) and half-fluence PDT in the management of chronic central serous chorioretinopathy.

Design: Systematic review and meta-analysis.

Methods: A comprehensive literature search was conducted on Ovid MEDLINE, Embase, and the Cochrane Library, covering publications from January 2000 to March 2024. The review focused on studies reporting the efficacy and safety of half-dose PDT compared to half-fluence PDT in treating chronic central serous chorioretinopathy. The primary outcome was the best-corrected visual acuity (BCVA) at the last study observation. Secondary outcomes included retinal thickness (RT), the presence of subretinal fluid (SRF), and SRF recurrence across follow-up visits. Random effects meta-analysis was performed using RevMan 5.4.

Results: A total of 10 studies (eight observational and two randomized controlled trials) were included in the analysis. The results indicated that half-dose PDT and half-fluence PDT achieved similar BCVA at 1 month (P = .24), 3 months (P = .40), and 6 months (P = .16). Similarly, there were no significant differences in RT at 1 month (P = .23), 3 months (P = .99), and at 6 months (P = .54) between the two treatment protocols. Both treatment protocols were associated with minor complications, indicating similar safety profiles in patients with CSCR.

Conclusions: The findings suggest that both half-dose and half-fluence PDT are effective and safe for treating CSCR, with no significant differences in BCVA, RT, or SRF resolution between the two modalities. These results support flexibility in selecting treatment based on individual patient needs. Further research with larger sample sizes and longer follow-up is required to optimize these protocols and confirm these results.

Publication types

Review