Half-dose photodynamic therapy for chronic central serous chorioretinopathy

Objective To observe the clinical effect of half-dose photodynamic therapy (PDT) for chronic central serous chorioretinopathy. Methods Thirty-two eyes of 27 patients (22 males and 5 females)with chronic central serous chorioretinopathy, diagnosed by best corrected visual acuity (BCVA) of logMAR, direct ophthalmoscope, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography, were enrolled. The age was ranged from 31 to 63 years old,with a mean of 45 years. The course of the disease was ranged from 6 to 32 months, with a mean of 16.2months. The logMAR BCVA was 1.6-0.1. The serous neuroepithelium detachment was found in 28 eyes,and serous neuroepithelium detachment combined with retinal pigment epithelium detachment (PED) was found in 4 eyes. The central retinal thickness was ranged from 184 to 465 μm, with a mean of 318.6 μm.All of the patients were treated with half dose PDT according to the methods in literatures. The above examinations were performed every 3 months after the treatment to observe the BCVA, subretinal fluid and retinal thickness. Results OCT showed that subretinal fluid were absorbed completely and retina remained attached in 25 of 28 eyes (89.3%) and 2 of 4 eyes (50.0%) with PED, while subretinal fluid were absorbed partly and retina attached incompletely in 3 of 28 eyes (10.7%) and 2 of 4 eyes (50.0%) with PED at the last visit. Twenty-seven eyes with retina remained attached, the mean central retinal thickness (CRT)decreased from (321.4±88.2) to (150.4±22.3) μm (t=9.09, P＜0.05); the mean logMAR BCVA improved from 0.68±0.09 to 0.44±0.07 0 = 2.65, P＜0.05). Among those, logMAR BCVA within 0. 32 were found in 12 eyes. There was a significant positive association between the CRT and BCVA (r=0. 96, P＜0. 01). No recurrence or side effect was observed at the last visit. Conclusion Half-dose PDT is a safe and effective approach for chronic central serous chorioretinopathy, especially for those without PED.\r\n\r\nKey words: \r\nRetinal diseases/therapy;  Choroid diseases/ therapy;  Photochemotherapy