Two-year Clinical Outcomes Following Photodynamic Acute Exudative Maculopathy in Patients with Chronic Central Serous Chorioretinopathy

Objective: To analyze the two-year clinical outcomes following photodynamic therapy (PDT)-induced acute exudative maculopathy (PAEM) in patients with chronic central serous chorioretinopathy (cCSCR). Methods: Prospective observational study that included 64 eyes of 64 patients with cCSCR who received half-fluence PDT and had a 2-year follow-up. Patients were classified into 2 groups based on whether they had had PAEM at 3 days after treatment (PAEM+, n=22; ≥50 µm increase in subretinal fluid (SRF) or not (PAEM-, n=42). Best-corrected visual acuity (BCVA) and SRF changes evaluated with optical coherence tomography (OCT) were registered at 3 days, 1 month, 3 months, 1 year and 2 years after PDT. The number of recurrences, the appearance of outer retinal atrophy (ORA) and choroidal neovascularization (CNV) were analyzed. Results: BCVA was 75.9±13.6 (20/32) and 82.0±11.0 letters (20/25) at two years in the PAEM+ and PAEM- groups, respectively (p=0.055). There were no differences in the BCVA change (4.2±7.7 vs 3.3±7.1 letters; p=0.654) and the SRF decrease (-117.3±74.2 vs -138.5±83.6 µm; p=0.323) at 2 years between patients with and without PAEM. No differences in the number of recurrences (p=0.267), the appearance of CNV (p=0.155) or ORA (p=0.273) between both groups were noted. Conclusions: Patients with cCSCR with and without PAEM presented similar results at 2 years in terms of BCVA gain, SRF reduction and complication rate.