Retinal pigment epithelial tear after half fluence PDT for serous pigment epithelial detachment in central serous chorioretinopathy.

Retinal pigment epithelial tears may occur after photodynamic therapy (PDT) in various diseases. The authors report a case of a retinal pigment epithelial tear after half light intensity (300 mW/cm2) PDT in a large serous pigment epithelial detachment associated with chronic atypical central serous chorioretinopathy. A 52-year-old woman with a large serous pigment epithelial detachment associated with chronic atypical central serous chorioretinopathy in the left eye received her first PDT treatment using verteporfin with a spot size of 6,640 microm, a duration of 83 seconds, and half (300 mW/cm2) of the standard 600 mW/cm2 light intensity, where the delivered PDT light dose was only 25 J/cm2. Two weeks later, visual acuity improved to 20/30. However, a large crescent-shaped retinal pigment epithelial tear was found during fundus examination. Even 50% reduced light fluence PDT can produce a retinal pigment epithelial tear in pigment epithelial detachment associated with chronic atypical central serous chorioretinopathy.