Half-dose photodynamic therapy for serous non-neovascular retinal pigment epithelial detachment

Abstract

Purpose: To investigate the efficacy of half-dose photodynamic therapy (PDT) for treating symptomatic serous non-neovascular pigment epithelial detachment (PED) and to identify factors associated with treatment outcome.

Patients and methods: This is a single-institute retrospective case series involving 12 eyes of 12 consecutive patients with serous non-neovascular PED who received half-dose PDT. We investigated the temporal change in best-corrected visual acuity (BCVA), the anatomic outcomes of PED, including recurrence, central choroidal thickness (CCT), and also choroidal thickness as a possible factor associated with treatment outcome.

Results: At baseline, mean logMAR BCVA was 0.06 (range Snellen equivalent 6/20 to 24/20); 24 months later, it was 0.01 (Snellen equivalent 6/20 to 24/20; P=0.3). At 3 months, PED had completely flattened in 8, decreased in height in 2, and remained unchanged in 2. The CCT in eyes with PED was 410 µm and thicker than that in fellow eyes (290 µm, P<0.0001). Recurrence was noted in 2 within 12 months after treatment. Eyes in which the choroidal thickness with a baseline CCT >350μm or a 100 µm difference in CCT responded favorably to half-dose PDT (P=0.02).

Conclusion: Half-dose PDT is effective in patients with non-neovascular PED. Thicker choroid and some difference in CCT between affected and fellow eye might be a good index for predicting the efficacy of this treatment.

Keywords:

• epithelial detachment
• serous pigment epithelial detachment
• non-neovascular pigment photodynamic therapy
• photodynamic therapy

Acknowledgment

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Disclosure

Hidenori Takahashi received lecturer’s fees/personal fees from Kowa Pharmaceutical, Novartis Pharmaceuticals, Bayer Yakuhin, Pfizer, Senju Pharmaceutical and Santen Pharmaceutical, grants from Bayer Yakuhin, Santen Pharmaceutical and Novartis Pharma, outside this work. He is also the founder of DeepEyeVision, LLC. Yuji Inoue received lecturer’s fees/personal fees from Kowa Pharmaceuticals, Novartis Pharmaceuticals, Bayer Yakuhin, Santen Pharmaceuticals, Alcon Pharmaceutical, and Senju Pharmaceutical, outside this work. Hidetoshi Kawashima received lecturer’s fees from Kowa Pharmaceutical, Novartis Pharmaceuticals, Santen Pharmaceutical, Senju Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Alcon Pharmaceuticals, outside this work. Yasuo Yanagi received lecturer’s fees from Novartis Pharmaceuticals, Santen Pharmaceutical, and Hoya Opticals, grants from Santen Pharmaceutical, and Novartis Pharmaceutlcals, outside this work. Dr Shinichi Sakamoto reports personal fees from Santen Pharmaceutical, Kowa Pharmaceutical, and Novartis Pharmaceutical, outside the submitted work. The authors report no other conflicts of interest in this work.