One-year results of reduced fluence photodynamic therapy for central serous chorioretinopathy: the outer nuclear layer thickness is associated with visual prognosis

Abstract

To evaluate the efficacy of reduced-fluence photodynamic therapy (RFPDT) for central serous chorioretinopathy (CSC). This retrospective medical record review of consecutive CSC patients treated with RFPDT (full-dose verteporfin and laser fluence of 25 J/cm(2)) examined 22 eyes of 21 patients (20 males and one female). All patients were followed-up for 1 year. Best-corrected visual acuity (BCVA), complete resolution of subretinal fluid (CR of SRF), central retinal thickness (CRT), the outer nuclear layer (ONL) thickness, and the photoreceptor inner and outer segments (IS/OS) line determined by optical coherence tomography imaging were evaluated at baseline, 1, 3, 6, 9, and 12 months after initial RFPDT. A single RFPDT session was performed in all cases during a 12-month period. CR of SRF was identified in all patients. BCVA significantly improved between 3 and 12 months (P < 0.05). The CRT significantly decreased between 1 and 12 months. A significantly thicker ONL was observed at 1 month, and 17 eyes (77.2 %) showed recovery of the continuous foveal IS/OS line. ONL thickness was correlated with BCVA at 12 months (P < 0.01). Stepwise analysis indicated that pre-treatment BCVA (P < 0.01) and ONL thickness (P < 0.01) were significant predictive factors for BCVA at 12 months. Neither ocular nor systemic adverse effects were observed during the follow-up period. RFPDT appears to be an effective treatment method for CSC. ONL thickness is an important visual predictive factor of RFPDT for CSC.