Photodynamic therapy in chronic central serous chorioretinopathy with subretinal fluid outside the fovea

PURPOSE: To assess the efficacy of photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC), in whom subretinal fluid (SRF) was solely present outside the foveal area. METHODS: In this retrospective study, 16 eyes of 15 cCSC patients who received half-dose PDT because of notable subjective visual complaints due to the presence of extrafoveal SRF, were included. An ophthalmic examination was performed before treatment, including Early Treatment Diabetic Retinopathy Study best-corrected visual acuity measurement, applanation tonometry, slit-lamp examination, and indirect ophthalmoscopy, followed by multimodal imaging, including fundus photography, fundus autofluorescence, spectral-domain optical coherence tomography (OCT), enhanced-depth imaging OCT of the choroid, fluorescein angiography, and indocyanine green angiography. RESULTS: In 7 treated patients (47%), PDT led to a decrease in visual complaints at the first evaluation visit. At this visit, extrafoveal SRF on OCT had resolved in 14 eyes (88%), whereas a complete resolution of extrafoveal SRF had occurred in all eyes at final follow-up visit. At baseline, posterior cystoid retinal degeneration was also present in 5 eyes (31%) and this remained present at all evaluation visits in these patients. Choroidal thickness decreased statistically significantly in the treated eyes, both foveally and at the location of the maximum height of extrafoveal SRF. No complications of PDT were observed. CONCLUSIONS: Half-dose PDT treatment of cCSC patients with visual complaints due to extrafoveal SRF accumulation is a safe procedure leading to complete SRF resolution, a decrease in choroidal thickness, and a reduction in visual symptoms. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00417-017-3720-z) contains supplementary material, which is available to authorized users.