Collaborative retrospective macula society study of photodynamic therapy for chronic central serous chorioretinopathy.
OBJECTIVE
To assess the visual and anatomic outcomes of central serous chorioretinopathy (CSC) after verteporfin photodynamic therapy (PDT).


METHODS
Retrospective case series.


METHODS
Patients with CSC who underwent PDT.


METHODS
Members of the Macula Society were surveyed to retrospectively collect data on PDT treatment for CSC. Patient demographic information, PDT treatment parameters, fluorescein angiographic information, optical coherence tomography (OCT) metrics, pre- and post-treatment visual acuity (VA), and adverse outcomes were collected online using standardized forms.


METHODS
Visual acuities over time and presence or absence of subretinal fluid (SRF).


RESULTS
Data were submitted on 265 eyes of 237 patients with CSC with a mean age of 52 (standard deviation [± 11]) years; 61 were women (26%). Mean baseline logarithm of the minimum angle of resolution (logMAR) VA was 0.39±0.36 (20/50). Baseline VAs were ≥20/32 in 115 eyes (43%), 20/40 to 20/80 in 97 eyes (37%), and ≤20/100 in 47 eyes (18%). Normal fluence was used for PDT treatment in 130 treatments (49%), half-fluence was used in 128 treatments (48%), and very low fluence or missing information was used in 7 treatments (3%). The number of PDT treatments was 1 in 89%, 2 in 7%, and 3 in 3% of eyes. Post-PDT follow-up ranged from 1 month to more than 1 year. Post-PDT VA was correlated with baseline VA (r = 0.70, P < 0.001). Visual acuity improved ≥3 lines in <1%, 29%, and 48% of eyes with baseline VA ≥20/32, 20/40 to 20/80, and ≤20/100, respectively. Subretinal fluid resolved in 81% by the last post-PDT visit. There was no difference in the response to PDT when analyzed by age, race, fluence setting, fluorescein angiography (FA) leakage type, corticosteroid exposure, or fluid location (subretinal or pigment epithelial detachment; all P > 0.01). Complications were rare: Retinal pigment epithelial atrophy was seen in 4% of patients, and acute severe visual decrease was seen in 1.5% of patients.


CONCLUSIONS
Photodynamic therapy was associated with improved VA and resolution of SRF. Adverse side effects were rare.
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois. Electronic address: jennylim@uic.edu.
Jennifer I
JI
Lim
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.
Adam R
AR
Glassman
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.
Lloyd Paul
LP
Aiello
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.
Usha
U
Chakravarthy
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.
Christina J
CJ
Flaxel
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.
Richard F
RF
Spaide
D056833:Central Serous Chorioretinopathy / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002908:Chronic Disease; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011166:Porphyrins / Q000009:adverse effects / Q000627:therapeutic use*; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin