Half-Dose Photodynamic Therapy Targeting the Leakage Point on the Fluorescein Angiography in Acute Central Serous Chorioretinopathy: A Pilot Study – Accepted Manuscript

Abstract: Purpose: To evaluate the efficacy of half-dose photodynamic therapy (PDT) targeting only the focal leakage point on fluorescein angiography for acute central serous chorioretinopathy (CSC).Design: Non-randomized, retrospective, comparative, interventional case series.Methods: Ten consecutive eyes with acute CSC underwent PDT and later 11 eyes were observed without treatment. Main outcome measures included achievement of complete resolution of subretinal fluid (SRF), change in best-corrected visual acuity, and central retinal sensitivity.Results: Complete resolution of SRF was achieved in 80.0% and 18.2% of eyes in the PDT group and the observation group at 1 month (P = .009), 100% and 27.3% at 3 months (P = .001), and 90% and 63.6% at 12 months (P = .311), respectively. At 12 months, three eyes (27%) in the observation group had a persistent lesion, while no such lesions were observed in the eyes in the PDT group. One eye in each group showed recurrence during the 12-month follow-up period. Visual acuity improved significantly in both groups at each time point, and the differences between groups were not significant. The mean central retinal sensitivity at 3 months was significantly higher in the PDT group compared with the observation group.Conclusions: Fluorescein angiography-guided half-dose PDT appears to facilitate faster resolution of SRF in acute CSC without however convincing long-term anatomical and functional benefits. This protocol may further enhance the safety of PDT.