Dealing with the Verteporfin Shortage: Treatment Options and Outcomes in Patients with Chronic and Non-Resolving Central Serous Chorioretinopathy.

IF 2.1 4区医学 Q2 OPHTHALMOLOGY

Ophthalmologica Pub Date : 2024-10-24 DOI:10.1159/000542224

Femke M van den Tillaart, Franca Hartgers, Carel B Hoyng, Suzanne Yzer

{"title":"Dealing with the Verteporfin Shortage: Treatment Options and Outcomes in Patients with Chronic and Non-Resolving Central Serous Chorioretinopathy.","authors":"Femke M van den Tillaart, Franca Hartgers, Carel B Hoyng, Suzanne Yzer","doi":"10.1159/000542224","DOIUrl":null,"url":null,"abstract":"Introduction: Half-dose photodynamic therapy (HD-PDT) with verteporfin is the mainstay treatment in central serous chorioretinopathy (CSC). Since 2021, there is a worldwide shortage of verteporfin. This called for adjustments of daily practice. Here, we provide a comprehensive evaluation of the adapted treatment methods and outcomes in patients with non-resolving and chronic CSC.Methods: In this retrospective cohort study, we compared patients referred in the year before the verteporfin shortage (group 1), with patients referred in the first year of verteporfin shortage (group 2). Treatment strategies, subretinal fluid (SRF) resolution, and visual acuity (VA) were evaluated during a follow-up period of at least 4 months.Results: Eighty-five eyes of 79 patients were analyzed, 36 eyes in group 1 and 49 in group 2. The treatment strategy at the first visit shifted from HD-PDT as the most performed treatment in group 1 to a more patient-tailored approach in group 2, with a wait-and-see policy in most cases. During follow-up, HD-PDT was performed significantly less in group 2 (89% vs. 45%; p < 0.001). At a mean follow-up time of 6.2 months, SRF resolved in 61% of the eyes in group 1 and in 55% in group 2 (p = 0.821). No difference in VA was observed between the groups at follow-up (p = 0.637).Conclusion: During the shortage of verteporfin, a different treatment strategy was applied, with HD-PDT being performed less frequently. By implementing a more patient-tailored approach, the VA and the resolution rate of SRF remained similar to the year before the shortage.","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-11"},"PeriodicalIF":2.1000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000542224","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Half-dose photodynamic therapy (HD-PDT) with verteporfin is the mainstay treatment in central serous chorioretinopathy (CSC). Since 2021, there is a worldwide shortage of verteporfin. This called for adjustments of daily practice. Here, we provide a comprehensive evaluation of the adapted treatment methods and outcomes in patients with non-resolving and chronic CSC.

Methods: In this retrospective cohort study, we compared patients referred in the year before the verteporfin shortage (group 1), with patients referred in the first year of verteporfin shortage (group 2). Treatment strategies, subretinal fluid (SRF) resolution, and visual acuity (VA) were evaluated during a follow-up period of at least 4 months.

Results: Eighty-five eyes of 79 patients were analyzed, 36 eyes in group 1 and 49 in group 2. The treatment strategy at the first visit shifted from HD-PDT as the most performed treatment in group 1 to a more patient-tailored approach in group 2, with a wait-and-see policy in most cases. During follow-up, HD-PDT was performed significantly less in group 2 (89% vs. 45%; p < 0.001). At a mean follow-up time of 6.2 months, SRF resolved in 61% of the eyes in group 1 and in 55% in group 2 (p = 0.821). No difference in VA was observed between the groups at follow-up (p = 0.637).

Conclusion: During the shortage of verteporfin, a different treatment strategy was applied, with HD-PDT being performed less frequently. By implementing a more patient-tailored approach, the VA and the resolution rate of SRF remained similar to the year before the shortage.

查看原文本刊更多论文

应对维替泊芬短缺：慢性和非缓解性中央浆液性脉络膜视网膜病变患者的治疗方案和疗效。

导言使用维替泊芬的半剂量光动力疗法（HD-PDT）是治疗中心性浆液性脉络膜视网膜病变（CSC）的主要方法。自 2021 年以来，verteporfin 在全球范围内出现短缺。这就要求对日常实践进行调整。在此，我们对非缓解期和慢性 CSC 患者所采用的治疗方法和疗效进行了全面评估。方法在这项回顾性队列研究中，我们将 verteporfin 短缺前一年转诊的患者（第 1 组）与 verteporfin 短缺第一年转诊的患者（第 2 组）进行了比较。在至少 4 个月的随访期间，对治疗策略、视网膜下积液（SRF）溶解情况和视力（VA）进行了评估。结果对 79 名患者的 85 只眼睛进行了分析，其中第 1 组 36 只，第 2 组 49 只。首次就诊时的治疗策略从第 1 组采用最多的 HD-PDT 治疗转变为第 2 组采用更适合患者的方法，在大多数情况下采取观望政策。在随访期间，第 2 组进行 HD-PDT 治疗的比例明显降低（89% 对 45%；P < 0.001）。平均随访时间为 6.2 个月，第一组中有 61% 的眼球 SRF 消失，第二组中有 55% 的眼球 SRF 消失（p = 0.821）。随访期间，两组的视力无差异（p = 0.637）。结论在verteporfin短缺期间，采用了不同的治疗策略，HD-PDT的实施频率较低。通过采用更适合患者的方法，VA 和 SRF 的治愈率与短缺前一年保持相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Ophthalmologica 医学-眼科学

CiteScore

5.10

自引率

3.80%

发文量

审稿时长

3 months

期刊介绍： Published since 1899, ''Ophthalmologica'' has become a frequently cited guide to international work in clinical and experimental ophthalmology. It contains a selection of patient-oriented contributions covering the etiology of eye diseases, diagnostic techniques, and advances in medical and surgical treatment. Straightforward, factual reporting provides both interesting and useful reading. In addition to original papers, ''Ophthalmologica'' features regularly timely reviews in an effort to keep the reader well informed and updated. The large international circulation of this journal reflects its importance.