Safety and Efficacy of Half-dose and Half-fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy: A Systematic Review and Meta-analysis.

IF 4.1 1区 医学 Q1 OPHTHALMOLOGY
Michele Zaman, Andrew Mihalache, Ryan S Huang, Nirmay Shah, Marko M Popovic, Peter J Kertes, Rajeev H Muni, Radha P Kohly
{"title":"Safety and Efficacy of Half-dose and Half-fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy: A Systematic Review and Meta-analysis.","authors":"Michele Zaman, Andrew Mihalache, Ryan S Huang, Nirmay Shah, Marko M Popovic, Peter J Kertes, Rajeev H Muni, Radha P Kohly","doi":"10.1016/j.ajo.2024.11.014","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the comparative efficacy and safety of half-dose photodynamic therapy (PDT) and half-fluence PDT in the management of chronic central serous chorioretinopathy (cCSCR).</p><p><strong>Design: </strong>Systematic review and meta-analysis METHODS: A comprehensive literature search was conducted on Ovid MEDLINE, Embase, and the Cochrane Library, covering publications from January 2000 to March 2024. The review focused on studies reporting the efficacy and safety of half-dose PDT compared to half-fluence PDT in treating cCSCR. The primary outcome was the best-corrected visual acuity (BCVA) at the last study observation. Secondary outcomes included retinal thickness (RT), the presence of subretinal fluid (SRF), and SRF recurrence across follow-up visits. Random effects meta-analysis was performed using RevMan 5.4.</p><p><strong>Results: </strong>A total of 10 studies (eight observational and two randomized controlled trials) were included in the analysis. The results indicated that half-dose PDT and half-fluence PDT achieved similar BCVA at 1 month (p=0.24), 3 months (p=0.40), and 6 months (p=0.16). Similarly, there were no significant differences in RT at 1 month (p=0.23), 3 months (p=0.99), and at 6 months (p=0.54) between the two treatment protocols. Both treatment protocols were associated with minor complications, indicating similar safety profiles in patients with CSCR.</p><p><strong>Conclusion: </strong>The findings suggest that both half-dose and half-fluence PDT are effective and safe for treating CSCR, with no significant differences in BCVA, RT, or SRF resolution between the two modalities. These results support flexibility in selecting treatment based on individual patient needs. Further research with larger sample sizes and longer follow-up is required to optimize these protocols and confirm these results.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.1000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajo.2024.11.014","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: To investigate the comparative efficacy and safety of half-dose photodynamic therapy (PDT) and half-fluence PDT in the management of chronic central serous chorioretinopathy (cCSCR).

Design: Systematic review and meta-analysis METHODS: A comprehensive literature search was conducted on Ovid MEDLINE, Embase, and the Cochrane Library, covering publications from January 2000 to March 2024. The review focused on studies reporting the efficacy and safety of half-dose PDT compared to half-fluence PDT in treating cCSCR. The primary outcome was the best-corrected visual acuity (BCVA) at the last study observation. Secondary outcomes included retinal thickness (RT), the presence of subretinal fluid (SRF), and SRF recurrence across follow-up visits. Random effects meta-analysis was performed using RevMan 5.4.

Results: A total of 10 studies (eight observational and two randomized controlled trials) were included in the analysis. The results indicated that half-dose PDT and half-fluence PDT achieved similar BCVA at 1 month (p=0.24), 3 months (p=0.40), and 6 months (p=0.16). Similarly, there were no significant differences in RT at 1 month (p=0.23), 3 months (p=0.99), and at 6 months (p=0.54) between the two treatment protocols. Both treatment protocols were associated with minor complications, indicating similar safety profiles in patients with CSCR.

Conclusion: The findings suggest that both half-dose and half-fluence PDT are effective and safe for treating CSCR, with no significant differences in BCVA, RT, or SRF resolution between the two modalities. These results support flexibility in selecting treatment based on individual patient needs. Further research with larger sample sizes and longer follow-up is required to optimize these protocols and confirm these results.

半剂量和半光束光动力疗法治疗慢性中央性浆液性脉络膜视网膜病变的安全性和有效性:系统回顾与元分析》。
目的:研究半剂量光动力疗法(PDT)和半流式光动力疗法在治疗慢性中心性浆液性脉络膜视网膜病变(cCSCR)中的疗效和安全性比较:系统综述和荟萃分析 方法:在 Ovid MEDLINE、Embase 和 Cochrane Library 上进行了全面的文献检索,涵盖 2000 年 1 月至 2024 年 3 月期间的出版物。综述的重点是报告半剂量 PDT 与半量 PDT 治疗 cCSCR 的疗效和安全性的研究。主要结果是最后一次研究观察时的最佳矫正视力(BCVA)。次要结果包括视网膜厚度(RT)、是否存在视网膜下积液(SRF)以及随访期间SRF的复发情况。使用RevMan 5.4进行随机效应荟萃分析:分析共纳入了 10 项研究(8 项观察性研究和 2 项随机对照试验)。结果表明,半剂量 PDT 和半能量 PDT 在 1 个月(p=0.24)、3 个月(p=0.40)和 6 个月(p=0.16)时的 BCVA 相近。同样,两种治疗方案的 RT 在 1 个月(p=0.23)、3 个月(p=0.99)和 6 个月(p=0.54)时也无明显差异。两种治疗方案均伴有轻微并发症,表明CSCR患者的安全性相似:研究结果表明,半剂量和半光照PDT治疗CSCR既有效又安全,两种模式在BCVA、RT或SRF分辨率方面没有显著差异。这些结果支持根据患者的个体需求灵活选择治疗方法。要优化这些方案并确认这些结果,还需要进行样本量更大、随访时间更长的进一步研究。
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
CiteScore
9.20
自引率
7.10%
发文量
406
审稿时长
36 days
期刊介绍: The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信