One-Year Outcomes with Half-Dose Verteporfin Photodynamic Therapy for Chronic Central Serous Chorioretinopathy

Purpose: To assess the 1-year outcome of half-dose verteporfin photodynamic therapy (PDT) for patients with chronic central serous chorioretinopathy (CSC). Design: Retrospective, interventional case series with no controls. Participants: A total of 204 eyes of 204 patients with chronic CSC were studied. Methods: Fluorescein angiography (FA) and indocyanine green angiography (ICGA) were performed before PDT. The best-corrected visual acuities (BCVAs) were measured and optical coherence tomography was performed before and 1, 3, 6, 9, and 12 months after PDT. Main Outcome Measures: The main outcome measures were the resolution of the serous retinal detachment (SRD), changes in BCVA, and ocular and systemic complications at 12 months. Results: A total of 182 of 204 eyes (89.2%) had complete resolution of the SRD at 12 months after the PDT. Eleven eyes (5.4%) had a persistent SRD throughout the follow-up period, and 12 eyes (5.9%) had a recurrence of the SRD after an earlier resolution. One of the 12 eyes had a spontaneous resolution of the SRD 6 months after PDT. The mean +/- standard deviation BCVA in logarithm of the minimum angle of resolution (logMAR) units significantly improved from 0.11 +/- 0.25 before to 0.07 +/- 0.23 at 1 month, 0.02 +/- 0.23 at 3 months, 0.01 +/- 0.23 at 6 months, 0.00 +/- 0.24 at 9 months, and -0.01 +/- 0.22 at 12 months (P < 0.0001). The eyes with an SRD at 12 months were more likely to have an intermediate hyperfluorescence on ICGA (chi-square test, P < 0.001) and poorer BCVA before the half-dose PDT (Student t test, P = 0.04) than those without SRD at 12 months. None of the patients developed any systemic complications or experienced any severe visual reduction after the half-dose PDT. However, polypoidal lesion appeared in 1 eye 8 months after the PDT. Conclusions: Half-dose PDT is an effective and safe method to treat eyes with chronic CSC with an SRD. The CSC resolved and the BCVA improved significantly after PDT. Half-dose PDT was less effective for cases without intense hyperpermeability on ICGA and those with lower BCVA before the PDT. (C) 2015 by the American Academy of Ophthalmology.