Clinical observation of photodynamic therapy with half dose of vepofin in the treatment of recurrent central serous choroidal retinopathy

Objective To investigate the clinical effect of photodynamic therapy with half dose of vepofin in the treatment of recurrent central serous choroidal retinopathy. Methods From June 2016 to May 2017, 8 patients (10 eyes) were diagnosed as recurrent central serous choroidal retinopathy in the second ophthalmology hospital of Chifeng, Inner Mongolia. All patients were treated with ventpophen photodynamic. According to the drug use standard of polycentric photodynamic therapy published in North America and Europe in 1999 for the treatment of age-related macular degeneration, the patient was determined. The patients were given half of the standard dose of routine photodynamic therapy, namely, according to the surface area of the patient, intravenous injection of venipofinn3 mg/m2, after the injection of 15 min, the light energy was 50 J/cm2, the power density was 600 mW/cm2, the laser wavelength of body laser was 689 nm, and the laser slit lamp irradiated 83 s. The changes of the best corrected visual acuity (BCVA) and retinal thickness (CMT) of the macular region were compared with the method of single factor repeated measurement of variance analysis. Results Before treatment, the BCVA of the patient was 0.2~0.5, the average was 0.34±0.12. After 3 months of treatment, the patient′s BCVA was 0.4~1.2, the average was 0.78±0.24. The visual acuity of the patients was significantly improved. The difference was statistically significant (t= -5.18, P<0.05). After3 months of treatment, all patients underwent optical coherence tomography. The results showed that 9 eyes of 8 patients (10 eyes) were completely cured, that is, the subretinal fluid of the fovea was completely absorbed, accounting for 90% of all patients. 1 eye was not completely cured, accounting for 10% of all patients. At 6 months after treatment, 8 patients (10 eyes) were completely cured after re examination by optical coherence tomography. The CMT before treatment was (349±91)μm, 1 month after treatment (192±60)μm, 3 months after treatment (184±64)μm, and 6 months after the treatment was (177±56)μm. Single factor repeated analysis of variance showed that there was a significant difference in CMT between patients at different time points (F=78.22, P<0.05). Compared with before treatment, the results of 1 month, 3 months and 6 months after treatment were significantly better than those before treatment, and the difference was statistically significant (t=4.32, 4.45, 4.83; P<0.05). After treatment, the CMT of patients showed a continuous decline. All patients were followed up for 1 month, 3 months and 6 months. At the last follow-up, no recurrence was found in the subretinal fluid and CMT of the fovea and no complications occurred. Conclusion The treatment of recurrent central serous choroidal retinopathy by using optical coherence tomography technique and half dose of veentfin photodynamic therapy can effectively improve the choroidal microcirculation and shorten the duration of the patient's course of disease, and the therapeutic effect is remarkable. Key words: Verteporfin; Photodynamic therapy; Recurrent central serous choroidal retinopathy