Purpose: To investigate the therapeutic outcomes, poor treatment response, and disease recurrence of reduced-dose photodynamic therapy (rPDT) in patients with chronic central serous chorioretinopathy (CSC).
Subjects and methods: Sixty-two eyes of 55 patients with chronic CSC which were administered rPDT were examined. We retrospectively investigated changes in visual acuity (VA), the characteristics of eyes with poor response as residual serous retinal detachment (SRD) and eyes with subsequent recurrence of SRD, and additional treatments.
Results: All 17 eyes (100%) with a baseline VA of 1.0 or more had preserved VA following rPDT. In the 26 eyes with a baseline VA of 0.5-1.0, VA was improved in two eyes (8%) and was maintained in 24 eyes (92%). In 19 eyes with a baseline VA of <0.5, VA was improved in seven eyes (37%), maintained in eight eyes (42%), and deteriorated in four eyes (21%). Following rPDT, SRD was completely resolved in 54 eyes (87%). Eight eyes (13%) showed poor treatment response and two eyes (3%) showed disease recurrence during the course of follow-up. Moreover, the patients with poor treatment response and disease recurrence received significantly more oral steroids (p=0.044). Of the eight eyes with poor treatment response, SRD was resolved in three of the four eyes that were administered additional rPDT, while SRD naturally resolved in only one of the remaining four eyes. In two of the four eyes with persistent SRD, SRD was resolved after anti-vascular endothelial growth factor (VEGF) therapy. Of the two eyes with disease recurrence, one improved following rPDT and one naturally improved.
Conclusions: rPDT was effective for all eyes with chronic CSC, and cases with a good baseline VA could maintain the positive VA following rPDT. In cases of poor treatment response, additional rPDT is effective and anti-VEGF therapy can also be effective in some eyes.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 693-699, 2018.