Visudyne is FDA-approved for management of exudative AMD but is probably much more commonly used off-label. According to the manufaturer’s label “Visudyne is not approved for use in other indications, in combination with another product, with reduced fluency, or with any other alteration to administration.” Both for exudative AMD and central serous chorioretinopathy photodynamic therapy with Visudyne is often applied at reduced fluence. Various papers and presentations, however, use the term “reduced fluence” to mean different things. Some papers describe half-fluence PDT to mean reducing the milliwatts delivered from 600 mW/cm2 to 300 mW/cm2. Other papers describe half-fluence PDT to mean reducing the total time of light energy delivery from 167 seconds to 83 seconds. Other papers describe half-fluence to mean reducing by half the dosage of Visudyne administered. This presentation highlights a case report of central serous chorioretinopathy in which varying the Visudyne dose administered in combination with varying the light energy delivered resulted in an apparent variable anatomic and visual response.

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Keye Wong