A combination therapy of half-dose verteporfin photodynamic therapy and intravitreal injection of ranibizumab for chronic central serous chorioretinopathy

Authors: YASİN TOKLU, HASAN BASRİ ÇAKMAK, MÜCELLA ARIKAN YORGUN, ŞULE BERK ERGUN, ŞABAN ŞİMŞEK

Abstract: Aim: To study the combination treatment consisting of half-dose verteporfin photodynamic therapy (PDT) and an intravitreal injection of ranibizumab as a potential treatment for patients with chronic central serous chorioretinopathy (CSC). Materials and methods: Six eyes of 6 patients were studied with fundus examination, fluorescein angiography, and optical coherence tomography to diagnose the maculopathy, monitor the detachments, and localize the choroidal hyperpermeability of the disorder. Half-dose verteporfin PDT was applied to areas of choroidal hyperpermeability and, the following day, 0.5 mg/0.05 mL ranibizumab was injected intravitreally. The patients were observed to determine the anatomic and functional outcomes. Results: The combination therapy consisting of half-dose verteporfin PDT and intravitreal injection of ranibizumab was associated with complete resolution of the exudative macular detachments in all of the patients. Vision improved in the 6 eyes and remained unchanged during the follow-up examinations, for at least more than 6 months. At 4 weeks after treatment, the best corrected visual acuity had improved to 20/20 in 5 of the cases. None of the patients had any treatment-related side effects. Conclusion: The combination therapy consisting of half-dose verteporfin PDT and intravitreal injection of ranibizumab seems to result in the resolution of exudative detachments in patients with chronic CSC. This treatment caused a rapid reduction in subretinal fluid and improvement in visual acuity. Although the follow-up time and the number of patients in this study were limited, the encouraging results and lack of complications suggest the value of further study.

Keywords: Central serous chorioretinopathy, intravitreal ranibizumab, photodynamic therapy

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