Long-term follow-up of half-fluence photodynamic therapy in acute central serous chorioretinopathy

To evaluate the long-term results of indocyanine green angiography(ICGA)-guided verteporfin (Visudyne®, Novartis, Basel, Switzerland) photodynamic therapy (PDT) with half-fluence rate in the treatment of acute symptomatic central serous chorioretinopathy (CSC).

A retrospective review was performed of 12 patients with acute symptomatic CSC verified by spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA), treated with ICGA-guided verteporfin (6 mg/m²)-PDT with half-fluence rate (25 J/cm²). The vision-related quality of life (VR QOL) 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) was completed by all patients and 82 controls.

Best corrected visual acuity (BCVA) at baseline was 77.5 (±10; n = 12) according to the Early Treatment Diabetic Retinopathy Study (EDTRS) letter score and changed to 89 letters (±9.9; p = 0.0003) at long-term follow-up (83.8 ± 4.8 months after PDT). Baseline contrast sensitivity (CS) was 29.5 ± 4.5 Pelli–Robson letters and increased to 34.5 ± 4.5 letters at long term (p < 0.0006). Baseline central foveal thickness (CFT) was 419 μm and decreased to 242 µm at long term (p < 0.0001). The long-term vision-related quality of life of patients was similar to that of controls.

ICGA-guided half-fluence PDT with verteporfin results in excellent long-term visual improvement in BCVA and CS, a significant reduction of CFT, and high levels of VR QOL.