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System review and meta‐analysis on photodynamic therapy in central serous chorioretinopathy
Author(s) -
Ma Jinlan,
Meng Nana,
Xu Xiaoyi,
Zhou Fang,
Qu Yi
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.12482
Subject(s) - photodynamic therapy , verteporfin , medicine , ophthalmology , serous fluid , visual acuity , placebo , meta analysis , urology , pathology , choroidal neovascularization , chemistry , alternative medicine , organic chemistry
Purpose To evaluate the effect of photodynamic therapy ( PDT ) on central serous chorioretinopathy ( CSC ) compared with laser therapy and intravitreal injection of anti‐vascular endothelial growth factor (anti‐ VEGF ) drugs, and to find the maximum treatment effect with minimal dose and fluence of PDT . Methods A systematic electronic search was conducted in Feb 2013 in PubMed, Embase, ISI Web of Knowledge and the Cochrane library. The main outcome factors were compared in best‐corrected visual acuity ( BCVA ), central macular thickness ( CMT ) and resolution of subretinal fluid ( SRF ). Meta‐analysis was performed when it is appropriate. The comparisons were designed into four groups: group 1, PDT versus laser photocoagulation; group 2, PDT versus intravitreal injection of anti‐ VEGF drugs; group 3, half‐dose verteporfin PDT versus placebo; group 4, half‐fluence PDT versus full‐fluence PDT . Results We retrieved nine reports of studies including a total of 319 patients. In group 1, the summary result indicated that PDT was superior in resolution of SRF (p = 0.005) than laser photocoagulation. In group 2, PDT could resolute SRF (p = 0.007) and decrease CMT (p = 0.002) more rapidly than intravitreal injection of anti‐ VEGF drugs. In group 3, half‐dose PDT was effective in improving BCVA (p < 0.00001), decreasing CMT (p = 0.001) and resolving SRF (p < 0.001). In group 4, half‐fluence PDT was effective and could significantly decrease the hypoxic damage which was caused by PDT (p < 0.001). Conclusion PDT is a promising therapy for CSC patients and the parameters of PDT can be adjusted to obtain the maximum treatment effect with minimal adverse effects.