Photodynamic Therapy With One Third Dose Verteporfin For Central Serous Chorioretinopathy

Purpose:To observe the therapeutic effect of photodynamic therapy (PDT) with one third dose verteporfin for central serous chorioretinopathy (CSC).Methods:42 patients (47 eyes) were diagnosed as CSC with 22 acute cases (22 eyes) and 20 chronic cases (25 eyes).38 cases were male and 4 cases were female, with a radio of 9.5:1. They age were ranged from 26 to 52 years, mean 42.1 years. All patients were accepted laser irradiation (689 nm) for 83s after injection of verteporfin (2mg/m2) 15min later. The follow-up time was lweek, lmonth,3months and 6 months. Compared the best corrected visual acuity (BCVA), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), optical coherence tomography (OCT) and observed the adverse reactions.Results:At 6 months follow-up, the BCVA of 42 patients (47 eyes) was found to be increased more than 2 lines in 23 eyes (48.9%), increased in 1 line in 14 eyes (29.8%), unchanged in 10 eyes (21.3%).1 months after PDT the OCT was found subretinal fluid completely absorbed in 44 eyes (93.6%); FFA and ICGA showed no leakage in 44 eyes (93.6%).6 months after PDT the OCT was found subretinal fluid completely absorbed in 47 eyes (100%); FFA and ICGA showed no leakage in 47 eyes (100%). The BCVA and OCT were found much better from pretreatment to 1 month and kept stability from 1 month to 6 months. After 1 month of the treatment, the BCVA in acute CSC was better than chronic CSC (P< 0.01). And the BCVA of the first with acute CSC posttreatment of 1 month was≥1.0, which was better than recurrent acute CSC (P< 0.05). The minimum thickness of macular center retinal nerve fiber layer (RNFL) of both acute and chronic CSC in pretreatment was significantly thicker than posttreatment (P< 0.01). The macular RNFL thickness in chronic CSC was obviously thinner than acute CSC (P< 0.01).1 month after PDT both BCVA (log MAR) and minimum thickness of macular RNFL were significantly associated (r=-0.808, P< 0.01).During the follow-up, recurrent in 2 cases, repeated treatment in 5 cases, no patients were found complications in systemic and fundus.Conclusions:1. PDT with verteporfin of one third dose for both acute and chronic CSC could improve symptoms, improve and maintain visual acuity, prevent or reduce the leakage from choroidal vascular, promote anatomical reposition of retinal and find no adverse reactions.2. Chronic CSC should accept laser as early as possible to improve visual acuity of prognosis. Especially for patients with leak point in or near macular center, PDT was suggested to be the first choice.