Purpose
To determine the effect of half-time reduced-fluence photodynamic therapy (RF-PDT) on macular function in eyes with chronic central serous chorioretinopathy (CSC).
Methods
Twenty-one eyes from 21 patients with chronic CSC of 6 months or more duration were studied. The dose and fluence of RF-PDT was administered according to the standard protocol for age-related macular degeneration (AMD), and laser was applied for 42 seconds guided by indocyanine green (ICG) angiographic images. The best-corrected visual acuity (BCVA) and the retinal sensitivity in the central 2- and 10-degrees were determined at the baseline and at 1, 3 and 6 months after the half-time RF-PDT. The retinal sensitivity was determined by Macular Integrity Assessment microperimetry (MAIA, Italy). Changes of the foveal thickness (CFT) and central choroidal thickness (CCT) were determined by optical coherence tomography (OCT).
Results
At the baseline, the mean retinal sensitivity was 19.0±4.60 dB in the central 2 degrees and 21.3±3.45 dB in the central 10 degrees. After half-time RF-PDT, the mean retinal sensitivity improved significantly to 22.5±3.54 dB in the central 2 and 24.3±2.48 dB in the central 10 at 1 month (P<0.001), to 24.2±3.26 dB in the central 2 and 24.4±1.98 dB in the central 10 at 3 months (P<0.001), and to 23.8±2.42 dB in the central 2 and 24.9 ± 2.06 dB in the central 10 (P<0.001).The BCVA was significantly improved at 3 months (0.11±0.22 logMAR units, P<0.05) and at 6 months (0.10±0.17 logMAR units, P<0.05) after half-time RF-PDT than at baseline (0.16±0.20 logMAR units). Six months after half-time RF-PDT, the SRF was resolved at all eyes. The CFT was significantly reduced from 289±77.8μm at baseline to 164±41.4μm at 1 month (P<0.001), 161±45.9μm at 3 months (P<0.001), and 172±35.7μm at 6 months (P<0.001). The CCT significantly improved from 405±105 μm at baseline to 332±97.2μm at 1 month (P<0.001), 340±93.2μm at 3 months (P<0.001), and 333±108μm at 6 months (P<0.001). At 6 months, none of the patients had any systematic or local adverse events associated with the half-time RF-PDT.
Conclusions
Half-time RF-PDT results in a significant improvement of the central retinal sensitivity over 6 months in eyes with chronic CSC. We conclude that half-time RF-PDT is beneficial for resolving chronic CSC by 6 months.
Keywords: 647 photodynamic therapy •
452 choroid