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Effectiveness of Reduced-fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Propensity Score Analysis

PURPOSE: To investigate the 2-year effectiveness of reduced-fluence photodynamic therapy (rf-PDT) for chronic central serous chorioretinopathy (cCSC). DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 223 consecutive patients with newly diagnosed cCSC with active serous retinal detachment...

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Autores principales: Aisu, Nao, Miyake, Masahiro, Hosoda, Yoshikatsu, Mori, Yuki, Takahashi, Ayako, Muraoka, Yuki, Ueda-Arakawa, Naoko, Miyata, Manabu, Oishi, Akio, Tamura, Hiroshi, Ooto, Sotaro, Yamashiro, Kenji, Tsujikawa, Akitaka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9560560/
https://www.ncbi.nlm.nih.gov/pubmed/36249695
http://dx.doi.org/10.1016/j.xops.2022.100152
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author Aisu, Nao
Miyake, Masahiro
Hosoda, Yoshikatsu
Mori, Yuki
Takahashi, Ayako
Muraoka, Yuki
Ueda-Arakawa, Naoko
Miyata, Manabu
Oishi, Akio
Tamura, Hiroshi
Ooto, Sotaro
Yamashiro, Kenji
Tsujikawa, Akitaka
author_facet Aisu, Nao
Miyake, Masahiro
Hosoda, Yoshikatsu
Mori, Yuki
Takahashi, Ayako
Muraoka, Yuki
Ueda-Arakawa, Naoko
Miyata, Manabu
Oishi, Akio
Tamura, Hiroshi
Ooto, Sotaro
Yamashiro, Kenji
Tsujikawa, Akitaka
author_sort Aisu, Nao
collection PubMed
description PURPOSE: To investigate the 2-year effectiveness of reduced-fluence photodynamic therapy (rf-PDT) for chronic central serous chorioretinopathy (cCSC). DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 223 consecutive patients with newly diagnosed cCSC with active serous retinal detachment (SRD) were included from May 2007 to June 2017 and followed up for at least 2 years. Patients who underwent ocular treatment other than cataract surgery before the beginning of recruitment and those who had macular neovascularization at baseline were excluded. METHODS: All patients underwent a comprehensive ophthalmic evaluation, including measurements of best-corrected visual acuity (BCVA), slit-lamp examination, dilated fundus examination, color fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and spectral-domain OCT. An inverse probability of treatment weighting (IPTW) methodology was applied to balance 18 baseline characteristics between patients who received rf-PDT (rf-PDT group) and those who did not receive treatment (controls). Inverse probability of treatment weighting survival analysis and regression were performed. MAIN OUTCOME MEASURES: The proportion of patients whose BCVA at 24 months was the same or improved compared with the baseline visual acuity (VA) (VA maintenance rate). RESULTS: A total of 155 eyes (rf-PDT group: 74; controls: 81) were analyzed. The patients’ backgrounds were well balanced after IPTW with standardized differences of < 0.10. An IPTW regression analysis revealed that the VA maintenance rate was significantly higher in the rf-PDT group than in the controls (93.6% vs. 70.9%, P < 0.001, 12 months; 85.7% vs. 69.8%, P = 0.019, 24 months). The rf-PDT group tended to show better VA improvement, but was not statistically significant (–0.06 vs. –0.008, P = 0.07, 12 months; –0.06 vs. –0.03, P = 0.32, 24 months). An IPTW Cox regression showed a significantly higher rate of complete SRD remission in the rf-PDT group (hazard ratio, 5.05; 95% confidence interval, 3.24–7.89; P < 0.001). CONCLUSIONS: The study suggests the beneficial effect of rf-PDT for cCSC for both VA maintenance and higher proportion of complete SRD remission in the clinical setting.
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spelling pubmed-95605602022-10-14 Effectiveness of Reduced-fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Propensity Score Analysis Aisu, Nao Miyake, Masahiro Hosoda, Yoshikatsu Mori, Yuki Takahashi, Ayako Muraoka, Yuki Ueda-Arakawa, Naoko Miyata, Manabu Oishi, Akio Tamura, Hiroshi Ooto, Sotaro Yamashiro, Kenji Tsujikawa, Akitaka Ophthalmol Sci Original Article PURPOSE: To investigate the 2-year effectiveness of reduced-fluence photodynamic therapy (rf-PDT) for chronic central serous chorioretinopathy (cCSC). DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 223 consecutive patients with newly diagnosed cCSC with active serous retinal detachment (SRD) were included from May 2007 to June 2017 and followed up for at least 2 years. Patients who underwent ocular treatment other than cataract surgery before the beginning of recruitment and those who had macular neovascularization at baseline were excluded. METHODS: All patients underwent a comprehensive ophthalmic evaluation, including measurements of best-corrected visual acuity (BCVA), slit-lamp examination, dilated fundus examination, color fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and spectral-domain OCT. An inverse probability of treatment weighting (IPTW) methodology was applied to balance 18 baseline characteristics between patients who received rf-PDT (rf-PDT group) and those who did not receive treatment (controls). Inverse probability of treatment weighting survival analysis and regression were performed. MAIN OUTCOME MEASURES: The proportion of patients whose BCVA at 24 months was the same or improved compared with the baseline visual acuity (VA) (VA maintenance rate). RESULTS: A total of 155 eyes (rf-PDT group: 74; controls: 81) were analyzed. The patients’ backgrounds were well balanced after IPTW with standardized differences of < 0.10. An IPTW regression analysis revealed that the VA maintenance rate was significantly higher in the rf-PDT group than in the controls (93.6% vs. 70.9%, P < 0.001, 12 months; 85.7% vs. 69.8%, P = 0.019, 24 months). The rf-PDT group tended to show better VA improvement, but was not statistically significant (–0.06 vs. –0.008, P = 0.07, 12 months; –0.06 vs. –0.03, P = 0.32, 24 months). An IPTW Cox regression showed a significantly higher rate of complete SRD remission in the rf-PDT group (hazard ratio, 5.05; 95% confidence interval, 3.24–7.89; P < 0.001). CONCLUSIONS: The study suggests the beneficial effect of rf-PDT for cCSC for both VA maintenance and higher proportion of complete SRD remission in the clinical setting. Elsevier 2022-04-06 /pmc/articles/PMC9560560/ /pubmed/36249695 http://dx.doi.org/10.1016/j.xops.2022.100152 Text en © 2022 by the American Academy of Ophthalmology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Aisu, Nao
Miyake, Masahiro
Hosoda, Yoshikatsu
Mori, Yuki
Takahashi, Ayako
Muraoka, Yuki
Ueda-Arakawa, Naoko
Miyata, Manabu
Oishi, Akio
Tamura, Hiroshi
Ooto, Sotaro
Yamashiro, Kenji
Tsujikawa, Akitaka
Effectiveness of Reduced-fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Propensity Score Analysis
title Effectiveness of Reduced-fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Propensity Score Analysis
title_full Effectiveness of Reduced-fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Propensity Score Analysis
title_fullStr Effectiveness of Reduced-fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Propensity Score Analysis
title_full_unstemmed Effectiveness of Reduced-fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Propensity Score Analysis
title_short Effectiveness of Reduced-fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Propensity Score Analysis
title_sort effectiveness of reduced-fluence photodynamic therapy for chronic central serous chorioretinopathy: a propensity score analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9560560/
https://www.ncbi.nlm.nih.gov/pubmed/36249695
http://dx.doi.org/10.1016/j.xops.2022.100152
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