Erfahrungen mit "half-dose" photodynamischer Therapie mittels Verteporfin bei Chorioretinopathia centralis serosa

Background: Chronic central serous chorioretinopathy (CSR) is an idiopathic, often self-limiting disease usually occurring in younger patients. A characteristic sign of CSR is a serous detachment of the neurosensory retina. Prognosis with regard to visual acuity is generally good. The disease is chronic or recurrent in up to 30% of cases. There is a risk for the development of secondary choroidal neovascularization. Therapeutic options include photocoagulation or photodynamic therapy (PDT) with verteporfin. In recent years there have been several approaches aiming to minimize the side-effects of PDT and the treatment protocols were designated half-dose, reduced fluence or low fluence PDT. Patients and Methods: A total of 7 eyes from 6 male patients with CSR were analyzed retrospectively. Beforehalf-dose PDT and at the end of follow-up best corrected visual acuity and retinal thickness were measured by spectral domain-optical coherence tomography. Results: The mean age of the patients was 40. 7 ± 10. 3 years, 5 eyes were treated with a single session of half-dose PDT (25 J / cm²), 1 with 2 PDTs and 1 with a total of 3 PDTs. Mean follow-up was 79. 8 ± 104. 5 months. Mean visual acuity (Snellen) before PDT was 0. 4 ± 0. 2 and 0. 4 ± 0. 3 after PDT (p = 0. 49). During the observation period the mean retinal thickness (RT) decreased from 479 μm ± 233 to 242 μm ± 60 (p = 0. 08). Conclusions: Half-dose PDT is a safe option for patients with long-standing CSR. All patients showed a decrease of retinal thickness, 6 eyes showed a total resolution of subretinal fluid and 5 eyes also showed functional improvement.