title: [Photodynamic therapy for chronic central serous chorioretinopathy and diffuse retinal epitheliopathy].
abstract: OBJECTIVE
  To report outcomes in patients with long-standing (more than 6 months) chronic central serous chorioretinopathy (CSC) treated with low-fluence Visudyne(®) photodynamic therapy (LFV-PDT).
  
  
  METHODS
  The clinical, angiographic and optical coherence tomography (OCT) results of patients with long-standing chronic central serous chorioretinopathy (CCSC) treated with LFV-PDT in the Lyon Centre Rabelais between 2002 and 2008 were retrospectively analyzed. A comprehensive check-up (macular syndrome signs, ETDRS best-corrected visual acuity [BCVA], biomicroscopy, fluorescein [FA] and indocyanine green [ICGA] angiographies, OCT scans) was performed before LFV-PDT treatment and 3 months later. Patients were then followed regularly and retreated in case of recurrence. The LFV-PDT treatment, with a fluence of 25 J/cm(2) at an irradiance of 300 mW, was guided by ICGA.
  
  
  RESULTS
  Forty-one eyes of 34 patients (27 males; mean age: 53 years) were included, of which 18 eyes had already been treated with laser photocoagulation. Several leaking points were visible on FA in most of the cases (n=38), mainly in the macula (35 cases). Before treatment, metamorphopsia was noted in 51% of the cases, intraretinal edema (IRE) was present on OCT scans in 71%, serous retinal detachment (SRD) in 85%, and pigment epithelial detachment (PED) in 10%. Thirty-nine eyes had only one treatment session and one eye was retreated once. At 3 months after LFV-PDT, IRE was present in 15% of the cases, SRD in 12%, and PED in 2%. At the end of the 20-month follow-up, IRE was present in 14% of the cases, SRD in 15%, and PED in 0%. Macular atrophy was observed on OCT in most of the cases at the end of the follow-up (mean central thickness, 144.5 μm). Compared to the initial BCVA, at 3 months after LFV-PDT, BCVA decreased in 22% of the cases, stabilized in 39%, and increased in 39%, while at the end of the follow-up, BCVA decreased in 12% of the cases, stabilized in 17%, and increased in 71%. No complication was observed.
  
  
  CONCLUSIONS
  LFV-PDT treatment for patients with long-standing chronic central serous chorioretinopathy results in anatomical and functional improvement (sustained disappearance of the exudative phenomenon in most cases and increased BCVA in more than two-thirds of the cases). The macular atrophy observed may be due to the treatment or the natural course of the disease.
authors: Service d'ophtalmologie, hôpital Édouard-Herriot, hospices civils de Lyon, université Lyon-1, 5, place d'Arsonval, 69437 Lyon cedex 03, France. pierre-loic.cornut@chu-lyon.fr
authors: P-L
authors: PL
authors: Cornut
authors: M
authors: M
authors: Quaranta-El Maftouhi
authors: M
authors: M
authors: Mauget-Faÿsse
mesh_terms: D000328:Adult; D000368:Aged; D056833:Central Serous Chorioretinopathy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011166:Porphyrins / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D012164:Retinal Diseases / Q000188:drug therapy* / Q000473:pathology; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology
chemical_list: D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin