To evaluate short and long-term functional and structural changes after half-dose photodynamic therapy (PDT) for central serous chorioretinopathy (CSC) and assess the prognostic effect of episode duration and history of previous episodes.


A retrospective study including acute and chronic CSC treatment-naïve patients submitted to half-dose PDT and followed for at least 6 months. Best corrected visual acuity (BCVA), mean central macular thickness (CMT) and mean central retinal sensitivity (CRS), were measured in both eyes, before and after PDT. A sub-group analysis comparing eyes with inaugural versus recurrent episode and eyes with less versus more than 3 months of fluid persistence (episode duration) was performed.


Sixty five eyes of 56 patients were included, with a mean follow-up period of 35.2 months (range 12-72). The sub-retinal fluid resolved completely in 93.7% 3 months after PDT and only 9 eyes (13.8%) recurred. Three months after PDT, significant improvement in BCVA and mean CRS (p<0.001) and decrease in mean CMT (p<0.05) were found and maintained stable until the last visit. Eyes with recurrent episodes presented worse final BCVA and CRS, especially within the central 4º (p=0.040) and 12º (p=0.048). Baseline and post-treatment BCVA and mean CRS were better in patients with a shorter episode duration (<=3 months). This trend prevailed regardless of being an initial or recurrent event.


The anatomical and functional retinal improvement found in a short-term period after PDT prevailed in a long-term assessment, with a good safety profile. History of previous episodes and the duration of each episode (persistence of sub-retinal fluid) seem to influence the outcomes. Our results suggest that better outcomes may be related with earlier CSC treatment.

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Susana Penas