Half-Fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: Predisposing Factors for Visual Acuity Outcomes

Purpose. To compare the efficacy and safety of subthreshold micropulse yellow wavelength laser (SMYL) and low-fluence photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSC).Methods. Thirty-three eyes of 30 patients with chronic CSC received either PDT (18 eyes) or SMYL (15 eyes) therapy. Best corrected visual acuity (BCVA), subretinal fluid (SRF) height, and central macular thickness (CMT) were evaluated at the baseline visit and one, three, six, nine, and 12 months after the therapy.Results. After 12 months, mean BCVA improved from67.3±14.2to71.5±21.4ETDRS letters in SMYL group and from60.7±16.3to64.4±24.9ETDRS letters in PDT group (p=0.285andp=0.440, resp.). Mean CMT decreased from242.8±80 μm to156.9±60 μm in the PDT group and from287.3±126 μm to138.0±40 μm in the SMYL group (p=0.098andp=0.003, resp.). SRF resolved completely in 72.2% and 80.0% of the eyes in the PDT and SMYL groups, respectively. Mean SRF height decreased from117.2±58 μm to31.3±56 μm in the PDT group and from130.0±104 μm to12.5±21 μm in the SMYL group (p=0.031andp=0.014, resp.).Conclusions. Subthreshold micropulse yellow wavelength laser seems to be effective in the treatment of chronic CSC without any side effect and results in the resorption of SRF without causing visible retinal scarring.

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Improvement of Low Luminance Visual Acuity in Patients with Chronic Central Serous Chorioretinopathy after Half-Dose Verteporfin Photodynamic Therapy

Journal of Clinical Medicine ◽

10.3390/jcm9123980 ◽

2020 ◽

Vol 9 (12) ◽

pp. 3980

Author(s):

Kyoko Fujita ◽

Kei Shinoda ◽

Yutaka Imamura ◽

Celso Soiti Matsumoto ◽

Koichi Oda

Keyword(s):

Visual Acuity ◽

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Serous Retinal Detachment ◽

Chronic Central Serous Chorioretinopathy ◽

Ellipsoid Zone ◽

Low Luminance ◽

Half Dose ◽

Postoperative Time ◽

Time Courses

Patients with central serous chorioretinopathy (CSC) often complain of visual difficulties under low luminance conditions. In this study, we evaluated low luminance visual acuity (LLVA) after half-dose verteporfin photodynamic therapy (hdPDT) in eyes with CSC. The study included eight eyes of eight patients with chronic CSC that underwent hdPDT. The best-corrected visual acuity, LLVA and optical coherence tomography (OCT) findings were evaluated at baseline, and at 1, 3, 6, 9, and 12 months after hdPDT. LLVA was measured at six levels of background luminance. Serous retinal detachment was completely resolved in all eyes. Although the mean LLVA at 1 month did not improve significantly compared to baseline at all luminance levels, significant improvements were observed at 3, 6, 9, and 12 months (p < 0.05). In OCT images, although the ellipsoid zone was not detectable in all eyes before hdPDT, it was observed in 2 eyes at 1 month, in 7 eyes at 3 months, and in all eyes from 6 months. The LLVA and the ellipsoid zone improved similarly with postoperative time courses. In conclusion, hdPDT improves LLVA in eyes with chronic CSC. The recovery of the ellipsoid zone may play a part in improving LLVA after hdPDT.

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