AIM: To review the clinical features and photodynamic therapeutic effect of patients with chronic central serouschorioretinopathy(CCSC).

METHODS: Fifteen eyes of eleven patients diagnosed as CCSC were treated with photodynamic therapy(PDT), whose clinical data were retrospectively reviewed. The best-corrected visual acuity(BCVA), fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA), optic coherence tomography(OCT)and fundus autofluorescence(FAF)before and after PDT were compared to evaluate therapeutic efficiency and safety of PDT on CCSC. The mean follow-up time was 10 months.

RESULTS: Mean age of the patients was 46.72±8.10 years. Mean duration of CCSC before PDT was 21.1±16.65 months. The mean log MAR BCVA at baseline was 0.50±0.22. The area of activefluorescein leakage was 1.27±1.45mm². Five eyes had leakage points within or near the foveal area, and 8 eyes had diffuse retinal pigment epithelium(RPE)decompensation with multiple window defect and multifocal leakage. ICGA revealed dilated choroid- capillaries and choroid hyperpermeability near the active leakage sites. Serous detachments of neurosensory retina were observed in 15 eyes on OCT, of which 7 eyes associated with RPE detachments. The mean foveal thickness was 297.27±107.23μm. Abnormal FAF alterations were detected in the area of retinal detachments and decompensation of RPE. After PDT treatment, the mean log MAR BCVA was 0.73±0.30 with significant improvement compared with before treatment(P<0.05). The mean area of fluorescein leakage was 0.05±0.12 mm² with statistically significant less compared with before PDT(P<0.05). The central foveal thickness decreased from 297.267±107.228μm to 173.733±38.944μm(P<0.05). The average time for absorption of subretinal fluid was 4.60±3.906 months. No serious adverse events were observed in treatment process and during the follow-up period.

CONCLUSION: Clinical features of CCSC include older age at onset and longer duration. Persistent serous retinal detachment of macular and diffuse decompensation of RPE may lead to permanent photoreceptor damage, consequently resulting in severe and irreversible visual loss. PDT with verteporfin could influence choroid vascular hyper-perfusion or hyper-permeability and help RPE to recover its normal structure and function, and thus facilitate the absorption of subretinal fluid and increased mean BCVA in eyes with CCSC, which provided an effective and safe treatment option for patients with CCSC.