Half-Dose Photodynamic Therapy for Bullous Variant Central Serous Chorioretinopathy: A Long-Term Follow-Up

To evaluate the long-term outcomes of half-dose half-dose photodynamic therapy (PDT) in the treatment of bullous variant central serous chorioretinopathy (bvCSC).

A retrospective single-center study of 18 patients, 31 eyes with bvCSC who received PDT between January 2012 and December 2021 with a minimum follow-up of 36 months.

During follow-up, a dry macula was achieved in all cases and no recurrence was witnessed. The mean number of PDT treatments was 1.2 sessions. Twenty-five (80.6%) eyes in 14 patients achieved complete fluid resolution after a single session. The earliest complete resolution of subretinal fluid occurred at 1 month, while the latest was at 12 months, with a mean time of 4.2 months. The subretinal fibrinous exudates were completely resolved in all affected eyes, with the earliest resolution observed at 1 month and the latest at 13 month, with an average time of 5.9 months. In seven (22.6%) eyes with pre-existing conditions, the subretinal fibrosis and scarring remained unchanged. The baseline average logMAR BCVA was 1.08 ± 0.55, and it improved to 0.74 ± 0.80 at final visit (P < 0.001), with visual gain stabilizing at 24 months. One eye (3.2%) with defects in the retinal pigmentary epithelium-choriocapillaris developed choroidal neovascularization 10 months after treatment.

Our clinical data suggested half-dose PDT might offer a favorable safety and efficacy profile in treating conventional bvCSC, with visual gain stabilizing at 24 months post-treatment. Cautious risk-benefit assessment remains essential for patients with high-risk ischemic anatomical features.