title: Reduced-fluence photodynamic therapy for subfoveal serous pigment epithelial detachment with choroidal vascular hyperpermeability.
abstract: OBJECTIVE
  To evaluate the efficacy of reduced-fluence photodynamic therapy (PDT) for treating symptomatic subfoveal serous pigment epithelial detachments (PEDs) with hyperfluorescence on late-phase indocyanine green angiography (ICGA) without choroidal neovascularization (CNV).
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  Fifteen eyes of 15 patients (mean age, 55.3 years) with a serous PED were included. Baseline ICGA showed hyperpermeable choroidal vessels but no CNV in any eyes. Reduced-fluence PDT was applied and included treatment of hyperfluorescent areas on late-phase ICGA. We evaluated changes in the PEDs and hyperfluorescence on late-phase ICGA at baseline and 3 months after PDT. We compared the subfoveal choroidal thickness and best-corrected visual acuity (BCVA).
  
  
  RESULTS
  The baseline ICGA showed mild to intense hyperfluorescence at the PED with hyperpermeable choroidal vessels. One month after reduced-fluence PDT, the PED resolved in 14 eyes (93%) and decreased in height in 1 eye. The PED flattening continued for more than 3 months. The baseline hyperfluorescence on ICGA decreased at month 3 except for 1 eye. The subfoveal choroidal thickness decreased significantly (P < .0001) from 297 to 238 μm; the BCVA significantly (P = .019) improved from 0.08 to -0.01 between baseline and month 3. The month-3 BCVA was significantly associated with the baseline BCVA and the duration and size of the PED. No PEDs recurred or complications developed, such as secondary CNV or retinal pigment epithelial tears.
  
  
  CONCLUSIONS
  Serous PEDs accompanying hyperfluorescence on ICGA are considered a variant of central serous chorioretinopathy. Reduced-fluence PDT is beneficial for resolving PEDs.
authors: Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: So
authors: S
authors: Goto
authors: Fumi
authors: F
authors: Gomi
authors: Chikako
authors: C
authors: Ueno
authors: Kohji
authors: K
authors: Nishida
mesh_terms: D000328:Adult; D000368:Aged; D002199:Capillary Permeability; D056833:Central Serous Chorioretinopathy / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002829:Choroid / Q000098:blood supply*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use; D012163:Retinal Detachment / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
chemical_list: D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D007208:Indocyanine Green