PHOTOBIOMODULATION THERAPY FOR SEROUS PIGMENT EPITHELIUM DETACHMENT IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY

To report a case of giant pigment epithelium detachment (PED) secondary to chronic central serous chorioretinopathy successfully treated with photobiomodulation.

This is a case report.

A 55-year-old man complained worsening of vision in the left eye over the last 18 months. A complete ophthalmological evaluation encompassing best-corrected visual acuity measurement, spectral-domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, and microperimetry was performed. Spectral-domain optical coherence tomography showed several small PEDs around the macula in the right eye and a giant macular serous PED with subretinal fluid in the left eye. Fluorescein angiography disclosed multiple hyperfluorescent roundish areas in the posterior pole bilaterally, with a macular pooling in the left eye. A diagnosis of chronic central serous chorioretinopathy was made, and the patient underwent photobiomodulation with one session for a week for 4 weeks, followed by one session bi-weekly for 2 months. Spectral-domain optical coherence tomography of the left eye showed a gradual flattening of the macular PED at 3 months, with a complete regression of the latter and of the subretinal fluid at 6-month and 12-month follow-up with no residual signs of chorioretinal atrophy on fundus autofluorescence. Best-corrected visual acuity improved from 20/80 at baseline to 20/25 at the last follow-up, and this functional improvement was further confirmed by microperimetry.

Photobiomodulation can be considered a safe and effective treatment strategy for the management of chronic central serous chorioretinopathy with subretinal fluid and serous PED.