Photodynamic therapy for acute central serous chorioretinopathy: the safe effective lowest dose of verteporfin.

Abstract

To find the lowest effective dose of verteporfin in the treatment of acute central serous chorioretinopathy with photodynamic therapy (PDT). Patients with acute central serous chorioretinopathy were chosen and treated with PDT with verteporfin. Decreasing doses of verteporfin were applied to the first 7 patients at 70%, 60%, 50%, 40%, 30%, 20%, and 10% of the full dose (6 mg/m). Other patients were treated with the effective lowest dose (30% of full dose). Fluorescein angiography, indocyanine green angiography, and optical coherence tomography recordings were performed before PDT and at 1 week, 2 weeks, 1 month, 3 months, 6 months, 9 months, and 12 months after PDT. The pretreatment and posttreatment best-corrected visual acuity were compared. Fifteen eyes of 15 patients with the diagnosis of acute central serous chorioretinopathy were chosen and treated with PDT. The results at each dose suggested that 30% of the full dose of verteporfin was the lowest effective dose. The mean improvement in visual acuity was 4.1 +/- 0.25 lines at follow-up (mean 11.8 months). No complications were found during observation, except 1 patient at 70% dose who developed retinal angiomatous proliferation at the 1-month follow-up. On the basis of the results of this study and available information regarding the expected rate of spontaneous resolution, 30% verteporfin dose seems to be safe and effective in the treatment of acute central serous chorioretinopathy.