Hawaiian Eye/Retina Meeting
Hawaiian Eye/Retina Meeting
Perspective from Pravin U. Dugel, MD
January 26, 2015
1 min read

PDT should be considered for chronic central serous chorioretinopathy

Perspective from Pravin U. Dugel, MD
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WAILEA, Hawaii — Retina specialists should consider photodynamic therapy as an adjunctive treatment for chronic central serous chorioretinopathy, according to a study presented here.

PDT has been impressively good,” Rishi P. Singh, MD, said at Retina 2015. “It’s really something to consider in those patients who have chronic CSR.”

According to results of the American Society of Retina Specialists’ PAT Survey, 64% of U.S. respondents used reduced-fluence PDT and 3.5% used standard-fluence PDT.

Additionally, 13.5% used intravitreal Avastin (bevacizumab, Genentech) and 3.8% used thermal laser. Small percentages of U.S. respondents used rifampin, finasteride, aspirin, RU486 or mifepristone or resorted to observation.

These agents increase cytochrome P450 enzymes in the liver, reduce cortisol levels in the body, and may block mineralocorticoid or glucocorticoid receptors, Singh said.

Verteporfin selectively occludes choroidal neovascularization and superficial choroidal vessels and has a minimal effect on overlying and deeper choroidal layers, Singh said.

Ninety percent of patients in the study had one PDT treatment, 7% had two and 3% had three; 51% underwent PDT with indocyanine green guidance.

Among eyes with baseline visual acuity of 20/32 or better, 26% gained two or more lines and 1% gained three or more lines.

Among eyes with baseline visual acuity of 20/40 to 20/80, 55% gained two or more lines and 29% gained three or more lines.

Among eyes with baseline visual acuity of 20/100 or worse, 59% gained two or more lines and 48% gained three or more lines.

“One concern about PDT has always been the acute vision loss following PDT treatment,” Singh said. “This occurred rarely, in about 1.5% of the patients who were studied in this group. Further prospective studies really need to be done to determine how this is going to end up being there for our patients.” – by Matt Hasson and Patricia Nale

Disclosure: Singh has financial relationships with Alcon, Genentech, Ophthotech, Regeneron, Shire Pharmaceuticals, ThromboGenics and Valeant.