Effectiveness and safety of repeated photodynamic therapy in recurrent central serous chorioretinopathy.

Purpose: To evaluate anatomical and functional outcomes after a second photodynamic therapy (PDT) in patients with central serous chorioretinopathy (CSC), who had a recurrence of subretinal fluid (SRF) after a previously successful PDT.

Methods: In this multicentre retrospective cohort study, we included patients with CSC who underwent a second PDT because of a recurrence of SRF after an effective first PDT with complete SRF resolution. Diagnosis of CSC was based on multimodal imaging. We evaluated the complete resolution rate of SRF after a second PDT with reduced settings. Also, visual acuity (VA), subfoveal ellipsoid zone (EZ) and subfoveal external limiting membrane (ELM) integrity before and after the first and the second PDT were studied.

Results: A total of 88 patients were studied, of whom 18% were female. The mean age was 51.3 ± 10.5 years at the second PDT. At the first follow-up visit after the second PDT (median of 44 days [IQR 40-51] after PDT), a complete resolution of SRF occurred in 64% of eyes. The median VA was 0.15 LogMAR before the second PDT and improved to 0.05 LogMAR (p < 0.001) after PDT. The EZ was continuous in 3% of patients before the second PDT, and EZ continuity increased to 27% at the first follow-up visit after PDT. No new atrophy was observed after the second PDT.

Conclusion: A second PDT with reduced settings in recurrent CSC is effective and safe in the short term, as significant anatomical and functional improvement was observed.