Extensive reduction in choroidal thickness after photodynamic therapy in eyes with central serous chorioretinopathy

We examined the effect of reduced fluence (rf)-photodynamic therapy (PDT) of the macular area on the wide-field choroidal thickness in 20 eyes with central serous chorioretinopathy (CSC) and 20 age- and sex-matched control eyes. The choroidal thickness at the posterior pole was measured before and after rf-PDT, using a grid with inner and outer rings, each divided into superotemporal, inferotemporal, superonasal, and inferonasal quadrants, respectively, making up a total of nine subfields including the central 3 mm ring. Before treatment, all eyes showed wide-field choroidal thickening from the dilated vortex vein ampulla to the fovea, along the course of the vein. After rf-PDT of the macular area, the choroidal thickness significantly decreased, not only in the irradiated macular area but also outside the arcade vessels in all quadrants (p < 0.001 for all inner subfields; p = 0.035 and p = 0.024 for the outer superonasal and inferonasal subfields, respectively; p < 0.001 and p = 0.004 for the outer superotemporal and inferotemporal subfields, respectively). For control eyes, the choroidal thickness did not differ between the initial visit and follow-up 1.2 & PLUSMN; 0.7 months after the initial visit (p > 0.05 for all subfields). These findings provide new insights into the pathogenesis of CSC and explain the reasons for the effectiveness of rf-PDT for this condition.

Automated summary

We investigated the change in wide-field choroidal thickness in patients with central serous chorioretinopathy (CSC) after reduced fluence photodynamic therapy (rf-PDT). The study found that before treatment, all eyes showed choroidal thickening, and after rf-PDT, the choroidal thickness significantly decreased in the irradiated macular area as well as outside the arcade vessels in all quadrants. The choroidal thickness did not differ in the control group between the initial visit and follow-up.