FA-guided photodynamic therapy beneficial in acute CSC

This small retrospective study found that fluorescein angiography (FA)-guided half-dose photodynamic therapy (PDT) may facilitate faster resolution of subretinal fluid in acute central serous chorioretinopathy (CSC).

Investigators reviewed the charts of 10 consecutive eyes with acute CSC that underwent FA-guided half-dose PDT targeting only the focal leakage point and 11 eyes with acute CSC that received no treatment.

Complete resolution of subretinal fluid was achieved in 80 percent of eyes in the PDT group and 18.2 percent in the no-treatment group at one month (P = 0.009); 100 percent and 27.3 percent, respectively, at three months (P = .001); and 90 percent and 63.6 percent at 12 months (P = 0.311).

Three eyes (27 percent) in the no-treatment group had a persistent lesion at 12 months, 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 authors conclude that half-dose photodynamic therapy with a small spot size covering the leaking point on fluorescein angiography may cause transient retinal pigment epithelial damage and subsequent remodeling, which induces faster anatomical and functional recovery compared with no treatment at all. Reducing the spot size of photodynamic therapy may reduce the potential complications.