Early Visual and Morphologic Changes After Half-Fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

Abstract

Purpose: To evaluate the early functional and morphologic changes in patients with chronic central serous chorioretinopathy (CSC) after half-fluence photodynamic therapy (PDT) and to compare with fellow eyes. Methods: This prospective study included 32 symptomatic and 28 fellow eyes of 32 patients with chronic CSC. Indocyanine green angiography-guided half-fluence PDT (25J/cm(2)) was performed. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), and subfoveal choroidal thickness (SFCT) were evaluated at baseline and at days 1, 3, 7, 30, and 60 after PDT. Results: The mean age was 48.17.9 years. Baseline BCVA [logarithm of the minimum angle of resolution (logMAR)] improved from 0.56 +/- 0.23 to 0.54 +/- 0.24, 0.45 +/- 0.25, 0.38 +/- 0.23, 0.36 +/- 0.23, and 0.35 +/- 0.21 at days 1, 3, 7, 30, and 60. (P=0.91, P=0.004, P=0.002, P=0.001, and P<0.001, respectively). Baseline CFT decreased from 315 +/- 131 to 312 +/- 136, 305 +/- 136, 235 +/- 106, 174 +/- 44, and 165 +/- 36m at days 1, 3, 7, 30, and 60 (P=0.41, P=0.33, P=0.004, P<0.001, and P<0.001, respectively). Baseline SFCT in the symptomatic eyes was significantly greater compared with the fellow eyes (P=0.002) and changed from 517 +/- 98 to 546 +/- 109, 528 +/- 110, 495 +/- 119, 462 +/- 124, and 457 +/- 123m at days 1, 3, 7, 30, and 60 (P=0.02, P=0.42, P=0.07, P=0.004, P=0.003, respectively). Conclusion: The SFCT in the symptomatic eyes was greater in the fellow eyes at baseline. Functional and morphological chorioretinal changes started in very early period of treatment. Half-fluence PDT for chronic CSC resulted in thinner CFT and SFCT, and also showed a significant improvement in visual acuity.