Three-Year Results of Fluorescein Angiography–Guided Standard Photodynamic Therapy with Multiple Spots for Central Serous Chorioretinopathy

Abstract

To report the long-term results of fluorescein angiography (FA)-guided standard photodynamic therapy (PDT) for central serous chorioretinopathy (CSCR) and its adverse effects. Prospective, noncomparative, interventional study. Consecutive patients (N= 63 eyes) with acute (39 eyes) or chronic (24 eyes) CSCR. All eyes underwent FA-guided conventional PDT, using multiple spots in 1 session if appropriate, and were assessed before PDT, as well as at months 3, 6, and 12 after PDT, and every 6 months thereafter until the end of the 3-year follow-up time. Primary outcome measures were the resolution of subretinal fluid (SRF) and the improvement of the Snellen best-corrected visual acuity (BCVA) to better than 20/100 at the end of the study. Secondary outcomes were the changes in mean BCVA and central foveal thickness (CFT) during the follow-up time. All 63 eyes with acute or chronic CSCR demonstrated complete resolution of SRF at the end of the study. Of the studied eyes, 51 (80.95%) underwent a single PDT application. The mean CFT improved significantly at all time points in the acute CSCR group (P < 0.001) from 515.13±110.5 μm to 297.75±22.3 μm at 3 years and in the chronic CSCR group from 484.12±62.49 μm to 293.81±16.89 μm. At 3 years, a gain of more than 20/100 in Snellen BCVA was seen in 28 acute and 16 chronic CSCR PDT-treated eyes (71.8% vs. 66.67%; P= 0.779). The mean logarithm of the minimum angle of resolution BCVA improved from 0.349±0.18 at baseline to 0.060±0.06 at the end of the study (P < 0.001) for eyes with acute CSCR and from 0.502±0.28 to 0.198±0.11 correspondingly for the eyes with chronic CSCR (P < 0.001). None of the study eyes demonstrated any serious systemic or ophthalmologic complication related to the use of the standard PDT with verteporfin. Fluorescein angiography-guided conventional PDT achieved outcomes for acute and chronic CSCR comparable with those reported with modified PDT techniques. We did not identify new safety concerns.