PURPOSE: To describe a case of chronic central serous chorioretinopathy with apparent transient, reversible loss of photoreceptor outer segments after half-fluence photodynamic therapy (PDT). METHODS: The authors reviewed the clinical and imaging records over a 2-year period of a case of chronic central serous chorioretinopathy treated with PDT. RESULTS: A 58-year-old man with a 3-year history of blurry central vision in his right eye due to persistent subretinal fluid associated with central serous chorioretinopathy elected to undergo half-fluence verteporfin PDT. Before treatment, visual acuity was 20/60, but 3 weeks after treatment, the patient returned complaining of significant worsening of vision to 20/200 and optical coherence tomography revealed resolution of subretinal fluid, but apparent loss of inner segment-outer segment band with preservation of the external limiting membrane. Twelve weeks after PDT, vision had recovered to 20/40 with reconstitution of inner segment-outer segment band under the fovea. The inner segment-outer segment band remained intact through the Month 22 follow-up visit. CONCLUSION: Severe visual loss can follow reduced fluence PDT for central serous chorioretinopathy. In this case, the mechanism of the loss appeared to be transient loss of the photoreceptor outer segments. The external limiting membrane remained intact in this case, a recovery of the outer segments with improvement in visual acuity was ultimately observed.
PURPOSE: To describe a case of chronic central serous chorioretinopathy with apparent transient, reversible loss of photoreceptor outer segments after half-fluence photodynamic therapy (PDT). METHODS: The authors reviewed the clinical and imaging records over a 2-year period of a case of chronic central serous chorioretinopathy treated with PDT. RESULTS: A 58-year-old man with a 3-year history of blurry central vision in his right eye due to persistent subretinal fluid associated with central serous chorioretinopathy elected to undergo half-fluence verteporfin PDT. Before treatment, visual acuity was 20/60, but 3 weeks after treatment, the patient returned complaining of significant worsening of vision to 20/200 and optical coherence tomography revealed resolution of subretinal fluid, but apparent loss of inner segment-outer segment band with preservation of the external limiting membrane. Twelve weeks after PDT, vision had recovered to 20/40 with reconstitution of inner segment-outer segment band under the fovea. The inner segment-outer segment band remained intact through the Month 22 follow-up visit. CONCLUSION: Severe visual loss can follow reduced fluence PDT for central serous chorioretinopathy. In this case, the mechanism of the loss appeared to be transient loss of the photoreceptor outer segments. The external limiting membrane remained intact in this case, a recovery of the outer segments with improvement in visual acuity was ultimately observed.