Isaac Alarcon, Daniel Vilaplana, Vladimir Poposki, M. Castilla, Xavier Acebes (Barcelona, Spain)

Advantages:

Photodynamic therapy (PDT) can be a useful and powerful tool to treat the different clinical forms of Central Serous Chorioretinopathy (CSC) and its possible complications.

Methods:

Classic CSC: PDT can be useful to treat CSC specially when the patient suffers more than one episode from the same focal leak in the fundus. We show case 1 chronic CSC: PDT is the first line treatment in this kind of CSC. The purpose of the treatment is to resolve the chronic retinal detachment and avoid recurrences of CSC. We show case 2 CNV secondary to CSC: For several years PDT has been the first line treatment for CNV, but anti-VEGF drugs largely replaced it. Despite of this, PDT is still a good option to treat CNV secondary to CSC. We show case 3.

Effectiveness / Safety:

In classic CSC the discussion is focused on deciding, if treatment is mandatory or not. If treatment is considered, laser photocoagulation, PDT or anti-VEGF drugs are the options. In chronic CSC, PDT or anti-VEGF drugs are the options. From those options, PDT achieves better long-term results in visual acuity. In CNV secondary to CSC, one can decide to use PDT, anti-VEGF drugs or a combination of both.

Take home message:

Despite the widespread use of anti-VEGF therapy for various macular diseases, PDT is still a useful and valuable therapy for CSC, showing good long-term results in terms of visual acuity and avoiding recurrences with very few complications.