To report the clinical outcomes of reduced-fluence photodynamic therapy (PDT) for symptomatic subfoveal retinal pigment epithelial detachment (RPED) in central serous chorioretinopathy and identify prognostic factors affecting treatment outcome.
This retrospective interventional study included 35 eyes of 35 patients with serous subfoveal RPED with choroidal hyperpermeability. Cases with evidence of age-related macular degeneration were excluded from the study. Reduced-fluence PDT was applied to each patient. Best-corrected visual acuity, anatomical resolution of RPED, subjective symptom improvement, and complications were analyzed.
One month after reduced-fluence PDT, 28 eyes (80.0%) manifested complete resolution of subfoveal RPED. Among the patients whose eyes manifested complete resolution, 19 (67.9%) reported subjective vision improvement. This subjective improvement was significantly associated with the presence of dysmorphopsia at baseline. Logarithm of the minimal angle of resolution visual acuity improved from 0.15 (Snellen equivalent of 20/28) to 0.09 (20/25) between baseline and 3 months after PDT (P = 0.008). Older age and increased RPED height were independent risk factors of poor resolution of RPED after PDT. The mean follow-up period after treatment was 10.4 ± 13.6 months; recurrence of RPED did not occur in any case.
Subfoveal RPED in central serous chorioretinopathy responded well to reduced-fluence PDT, especially in younger patients with less RPED. Dysmorphopsia, rather than decreased visual acuity, is a main symptomatic presentation in subfoveal RPED.
Symptomatic subfoveal retinal pigment epithelial detachment without subretinal fluid in central serous chorioretinopathy responded well to reduced-fluence photodynamic therapy. Younger patients with smaller retinal pigment epithelial detachment height tended to have better results. Dysmorphopsia seems to be a key symptom of subfoveal retinal pigment epithelial detachment in central serous chorioretinopathy.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Reprint requests: Se Woong Kang, MD, PhD, Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea; e-mail: firstname.lastname@example.org
None of the authors has any financial/conflicting interests to disclose.
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