Oscillatory photodynamic therapy in central serous chorioretinopathy

To assess the effects of oscillatory photodynamic therapy (OPDT) with verteporfin in patients with chronic central serous chorioretinopathy (cCSCR).

Retrospective study including eyes with cCSCR who underwent OPDT by a single retina specialist. Best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and subretinal fluid (SRF) height were assessed before and after OPDT. Full dose verteporfin was administered with half-fluence protocol. During the procedure, the laser beam was oscillated at 2-3 Hertz with the lens steady, treating areas with hyperpermeability on indocyanine green angiography (ICGA). Linear mixed models were used to compare BCVA, CMT, SRF height, and SFCT before and after treatment.

A total of 28 eyes of 20 patients were included, mean age was 52.71 ± 13.22, and 4 were females (20%). OPDT involving the fovea was performed in 46.42% of the cases. After a mean of 12.57 ± 8.10 months, complete resolution of SRF was observed in 89.28% of eyes, with a full resolution after the first OPDT in 78.57%. Overall, BCVA improved from 0.21 ± 0.17 to 0.11 ± 0.11 logMar (p = 0.003), and CMT, SFCT, and SRF height showed a significant decrease at the last follow-up assessment (p = 0.007; p = 0.001; and p = 0.002 respectively). BCVA was similar in eyes treated with extra-foveal and foveal OPDT (p = 0.963). No major complications were observed at 12-month follow-up.

OPDT including foveal application is a safe and effective treatment in cCSCR, with complete resolution of SRF in almost 90% of cases with minimal changes or recurrence.