Photodynamic therapy on chronic pathology during the post-COVID19 and worldwide shortage of verteporfin (Visudyne®) era

Abstract

Background: We analyze COVID19 pandemia and shortage of verteporfin (Visudyne®) consequences in photodynamic therapy (PDT) treated patients.

Material and methods: A retrospective study was performed in 97 patients treated with PDT last 3 years. We used HALF DOSE PDT for chronic central serous chorioretinopathy (cCSCR) (n = 84) and FULL DOSE for polypoidal choroidal vasculopathy (PCV) (n = 13). We evaluated changes in visual acuity (VA) and resolution of subretinal fluid (SRF) by optical coherence tomography (OCT), assessing the number of retreatments.

Results: The mean referral delay time was 28.5 ± 6.24 months. 53.6 % of cCSCR and 75 % of PCV patients received previous treatments. An improvement in VA was observed in cCSCR patients after treatment, while PCV patients tends to stabilization. Patients with longer therapeutic delay (≥1 year) showed worse VA. Complete resolution of SRF was noted in 71.4 % of cCSCR and 83.3 % of PCV patients. The shorter the referral delay, the better the resolution rate (76.9 % < 1 year vs 61.5 % if ≥1 year). One-third-of patients required retreatment, superior if longer delay (26.9 % if <1 year vs 34.3 % if ≥1 year).

Conclusion: Even with referral delay or chronic evolution, PDT is worth it and safe to resolve SRF or polyps activity for cCSCR and PCV.

Keywords: Central serous chorioretinopathy; Multimodal retinal imaging; Pachychoroid; Photodynamic therapy; Polypoidal choroidal vasculopathy; Verteporfin shortage.