Background: We report a case in which subretinal fluid (SRF) associated with choroidal nevus was successfully treated with low-dose photodynamic therapy (PDT).
Case: A 49-year-old man was referred to our clinic for detailed evaluation of asthenopia and anorthopia in the right eye. At the initial visit, he had the visual acuity of 0.08 in the right eye (1.0×-2.75 D＝cyl-0.75 D Ax 170°). Funduscopy revealed a blackish-brown pigment change in the macula of the right eye. Optical coherence tomography revealed SRF in the macular region and a choroidal elevation, of which the surface was bright and reduced brightness of the interior. There were no remarkable findings in his left eye. Fluorescein angiography revealed hyperfluorescent dots inside the elevated lesion in the early stage and a leakage slightly increasing toward the late stage. Indocyanine green angiography revealed an approximately 4.8 mm hypofluorescent plaque consistent with the funduscopic findings. The patient was considered to have SRF associated with damage to the retinal pigment epithelium in the choroidal nevus and thus underwent low-dose PDT. As a result, the SRF improved and completely disappeared in one year after PDT. No relapses of SRF occurred until he experienced SRF again approximately 3 years after the treatment. Thus, he underwent a repeated low-dose PDT, and a decrease in SRF could be confirmed.
Conclusions: PDT was effective for the treatment of SRF associated with choroidal nevus in our case. However, recurrence of SRF is possible because PDT is not a definitive treatment for the nevus. Therefore, long-term follow-up after treatment is necessary.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 128: 119-126, 2024.