Relationship between photoreceptor layer changes before half-dose photodynamic therapy and functional and anatomic outcomes in central serous chorioretinopathy

Objectives To investigate the relationship between photoreceptor layer (PRL) changes before half-dose photodynamic therapy (PDT) and functional and anatomic outcomes in central serous chorioretinopathy (CSC). Methods Baseline PRL changes were classified based on optical coherence tomography: (1) smooth PRL outer border without a foveal PRL defect; (2) smooth PRL outer border with a foveal PRL defect; (3) granulated PRL outer border and (4) scattered dots of PRL. The best-corrected visual acuity (BCVA), difference in the foveal outer nuclear layer (ONL) thickness between the CSC and normal contralateral eyes and ellipsoid zone (EZ) integrity 12 months after half-dose PDT were compared. Results In total, 132 patients were included. Group 4 eyes had rather poor BCVA (20/2000-20/400) with little improvement (P = 0.088) at 1 year following half-dose PDT. In the other groups, the mean BCVA improved significantly to 20/25 or better (allP < 0.001). Group 1 eyes had the smallest foveal ONL thickness reduction (-5.12 +/- 6.89 mu m) and intact EZs (33/33), whereas Group 4 eyes had the largest foveal ONL thickness reduction (-70.00 +/- 7.87 mu m) and disrupted EZs (4/4). Group 2 and Group 3 eyes behaved similarly: they both had notable foveal ONL thickness reductions (-19.21 +/- 18.53 and -20.75 +/- 17.62 mu m, respectively), but usually continuous EZs (18/19 and 69/76, respectively). Conclusions The PRL change category before half-dose PDT was closely related to functional and anatomic outcomes. This information could aid clinicians to better determine the timing of treatment with half-dose PDT in CSC.

Automated summary

The study investigated the relationship between changes in the photoreceptor layer (PRL) before half-dose PDT and functional and anatomical outcomes in CSC. The results showed that different PRL change categories were closely related to visual acuity and anatomical changes after treatment, providing valuable information for clinicians to determine the optimal timing for half-dose PDT in CSC patients.