Oscillatory photodynamic therapy for choroidal neovascularization and central serous retinopathy; a pilot study

ABSTRACT

To report the preliminary results of oscillatory photodynamic therapy [OPDT] for choroidal neovascularization [CNV] and central serous retinopathy [CSR]. This study included 7 eyes of 6 patients with CSR [2 eyes], idiopathic CNV [2 eyes], CNV due to age-related macular degeneration [AMD] [2 eyes], and peripapillary CNV secondary to presumed ocular histoplasmosis syndrome [1 eye]. Intravenous verteporfin [6 mg/m[2] body surface area] was infused over 10 minutes followed by oscillating laser [wavelength 689 nm] covering slightly beyond the entire lesion. An Area Centralis lens was applied and laser was delivered [600 mW/cm[2] fluence rate and 50 J/cm[2] dose]. Intravitreal bevacizumab and dexamethasone combination therapy was used with OPDT in 4 eyes with CNV; intravitreal dexamethasone and triamcinolone acetonide were injected in the other eye with CNV. Clinical examination, funduscopy, fluorescein angiography, and optical coherence tomography [OCT] were performed at baseline and after treatment. After mean follow-up of 7.1 +/- 5.1 months, visual acuity improved from 0.87 +/- 0.69 logMAR [20/160] to 0.60 +/- 0.65 logMAR [20/80] [P = 0.027]; central foveal thickness decreased from 322 +/- 62.1 to 240.7 +/- 34.8 microns as measured by OCT [P = 0.018]. Fluorescein angiography and OCT demonstrated cessation of vascular leakage, and resolution of hemorrhage and subretinal fluid in all eyes. No adverse events or recurrence were noted. OPDT was effective in treating CNV lesions and CSR. OPDT may be an improvement on standard PDT due to reduced side effects, thermal damage and scarring