Low-fluence photodynamic therapy in londstanding chronic central serous chorioretinopathy with foveal and gravitational atrophy

Purpose. To describe anatomic and functional outcomes in two patients with long-standing severe chronic central serous chorioretinopathy (CSC) with foveal and gravitational atrophy treated with low-fluence photodynamic therapy (PDT). Methods. Two patients with a history of over 10 years of chronic CSC and development of gravitational tracts, with best-corrected visual acuity ≤20/200, were treated with PDT guided by indocyanine green angiography (ICGA) with a fluence of 25 J/cm2 at an irradiance of 300 mW. Follow-up examinations 1 and 9 months after therapy included measurement of near and far best-corrected visual acuity, fundus biomicroscopy, fluorescein angiography and ICGA, optical coherence tomography, and microperimetry. Results. At 1 and 9 months after low-fluence PDT, complete resolution of subretinal, intraretinal, and under retinal pigment epithelium fluid was observed in both patients. Far and near visual acuity improved in both eyes. Improvement of sensitivity and fixation stability were demonstrated by microperimetry. No treatment-related side effects were seen. Conclusions. ICGA-guided low-fluence PDT seems effective and safe for treating long-standing chronic CSC. © Wichtig Editore, 2009.