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.

中文翻译：

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半剂量和半通量光动力疗法治疗慢性中央浆液性脉络膜视网膜病变的安全性和有效性：系统评价和荟萃分析。


目的 探讨半剂量光动力疗法 （PDT） 和半通量 PDT 治疗慢性中枢性浆液性脉络膜视网膜病变 （cCSCR） 的疗效和安全性。设计 系统评价和荟萃分析方法： 在 Ovid MEDLINE、Embase 和 Cochrane 图书馆进行了全面的文献检索，涵盖了 2000 年 1 月至 2024 年 3 月的出版物。本综述侧重于报告半剂量 PDT 与半通量 PDT 治疗 cCSCR 的疗效和安全性的研究。主要结局是最后一次研究观察时的最佳矫正视力 （BCVA）。次要结局包括视网膜厚度 （RT） 、视网膜下液 （SRF） 的存在和随访中的 SRF 复发。使用 RevMan 5.4 进行随机效应荟萃分析。结果 共纳入 10 项研究 （8 项观察性试验和 2 项随机对照试验）。结果表明，半剂量 PDT 和半通量 PDT 在 1 个月 （p=0.24） 、 3 个月 （p=0.40） 和 6 个月 （p=0.16） 时达到相似的 BCVA。同样，两种治疗方案在 1 个月 （p=0.23） 、 3 个月 （p=0.99） 和 6 个月 （p=0.54） 时的 RT 无显著差异。两种治疗方案都与轻微并发症相关，表明 CSCR 患者的安全性相似。结论 研究结果表明，半剂量和半通量 PDT 对治疗 CSCR 都是有效和安全的，两种方式之间的 BCVA 、 RT 或 SRF 分辨率没有显着差异。这些结果支持根据个体患者需求灵活选择治疗。需要更大的样本量和更长的随访时间进行进一步研究，以优化这些方案并确认这些结果。