Outcomes of Treatment for Central Serous Chorioretinopathy With Half-Fluence, Half-Dose Photodynamic Therapy

Purpose: To determine outcomes in eyes with central serous chorioretinopathy (CSCR) treated with half-half photodynamic therapy (PDT). Methods: This retrospective cohort review included patients with CSCR treated with half-half PDT at Alberta Retina Consultants between July 2007 and July 2023. Exclusion criteria included concomitant ocular disease or history of ocular surgery, intraocular injection, or laser therapy in the treated eye. The primary outcome was posttreatment visual acuity change. Secondary outcomes included central subfield thickness (CST) and fluid resolution assessed at 3 months, in addition to fluid recurrence, need for retreatment, and reports of adverse events at any timepoint after PDT. Results: Three hundred and seventy-eight eyes were included, with a mean time to treatment from presentation of 4.6 months. There was a statistically significant visual gain of 4.4 Early Treatment Diabetic Retinopathy Study letters with treatment (P < .05). Complete resolution of fluid was seen in 56.8% of eyes 3 months' posttreatment. Complete resolution at 6 months was seen in 64.0% of eyes. Recurrence was seen in 16.7% of eyes. There were no cases of macular atrophy secondary to PDT. Over the study period, pachychoroid neovasculopathy was identified in 3.4% of treated eyes. Conclusions: Half-half PDT for active CSCR yielded improvements in both best-corrected visual acuity and CST. Half-half PDT is a safe alternative treatment option that is slightly less effective than half-dose, full-fluence PDT.