title: Multiple spots of photodynamic therapy for the treatment of severe chronic central serous chorioretinopathy.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of fluorescein angiography (FA)-guided photodynamic therapy (PDT) for the treatment of severe chronic central serous chorioretinopathy (CSC).
  
  
  METHODS
  Patients presenting with chronic CSC with multiple areas of retinal pigment epithelium decompensation, with or without focal leaks, were treated with FA-guided full-fluence PDT. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), FA, indocyanine green angiography, and fundus autofluorescence were used to determine functional and anatomic outcomes.
  
  
  RESULTS
  Twenty-one eyes (17 patients) were treated with PDT and followed for a median of 24 months (range, 12-73). In fourteen eyes (66.66%), two PDT spots were performed within the same session. In three eyes (14.28%), three PDT spots were performed, in two eyes (9.52%) four spots, and in two eyes (9.52%) five spots. In 17 eyes (80.95%), the leakage in FA and the subretinal fluid in OCT disappeared after only one session of PDT. In four eyes (19.05%), a second session - with only one spot - of PDT was required due to persistent or recurrent leakage and subfoveal SRF. Median BCVA improved significantly from 20/63 at baseline to 20/40 at 3 months (P = 0.0002) and 20/32 at 6 months (P < 0.0001), and remained improved until the last examination (20/25, P < 0.0001). Two patients complained of a transient central scotoma after the treatment.
  
  
  CONCLUSIONS
  FA-guided full-fluence PDT with multiple PDT spots within the same session seems to be effective and safe for the treatment of chronic CSC cases with multiple areas of retinal pigment epithelium decompensation.
authors.affiliation: First Department of Ophthalmology, Medical School of Athens University, Athens, Greece.
authors.forename: George D
authors.initials: GD
authors.lastname: Tsakonas
authors.forename: Athanasios I
authors.initials: AI
authors.lastname: Kotsolis
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Koutsandrea
authors.forename: Ilias
authors.initials: I
authors.lastname: Georgalas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Papaconstantinou
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Ladas
keywords: central serous chorioretinopathy; photodynamic therapy