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. 2025 Mar 18;11(1):32.
doi: 10.1186/s40942-025-00657-6.

Comparative efficacy of half-dose and one-third-dose photodynamic therapy in chronic central serous chorioretinopathy: a retrospective study

Mohsen Farvardin  1 , Dorna Eghtedari  1 , Maryam Shahmohammadi  1 , Mohammadkarim Johari  2
Affiliations

Comparative efficacy of half-dose and one-third-dose photodynamic therapy in chronic central serous chorioretinopathy: a retrospective study

Mohsen Farvardin et al. Int J Retina Vitreous. .

Abstract

Purpose: To compare the efficacy and safety of half-dose and one-third-dose photodynamic therapy (PDT) with verteporfin in patients with chronic central serous chorioretinopathy (CSC).

Methods: This retrospective study included 72 eyes from 72 patients with chronic CSC treated with either one-third-dose (2 mg/m²) or half-dose (3 mg/m²) PDT. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), subretinal fluid (SRF) thickness, subfoveal choroidal thickness (SFCT), and optical coherence tomography (OCT) features were evaluated at baseline, 3 months, and 12 months. Fluorescein angiography (FA) was used to guide laser application. Treatment outcomes, including SRF resolution, BCVA gain, and recurrence rates, were compared between the two groups.

Results: At 12 months, complete SRF resolution was achieved in 40 eyes (78.4%) in the half-dose group and 15 eyes (71.4%) in the one-third-dose group. The recurrence rate of SRF was significantly higher in the one-third-dose group (20%) compared to the half-dose group (7.5%) (P =.015). BCVA improved significantly in both groups, with mean increases from 72.4 ± 3.9 to 77.1 ± 5.6 letters in the one-third-dose group and from 74.4 ± 4.2 to 80.2 ± 2.19 letters in the half-dose group. The proportion of patients achieving a ≥ 10-letter gain was higher in the half-dose group (52%) compared to the one-third-dose group (28.5%, P =.001). Both groups exhibited significant reductions in CRT, SRF thickness, and SFCT (P <.001), with no significant intergroup differences. Baseline CRT and fluorescein leakage patterns influenced treatment response.

Conclusions: Both one-third-dose and half-dose PDT effectively improved visual and anatomical outcomes in patients with chronic CSC. However, half-dose PDT demonstrated superior efficacy in achieving SRF resolution and greater visual acuity gains with a lower recurrence rate.

Clinical trial number: Not applicable.

Keywords: Choroidal thickness changes; Chronic central serous chorioretinopathy (CSC); Reduced-dose photodynamic therapy (PDT); Subretinal fluid resolution; Visual acuity improvement.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The protocol used in this study was approved by the Ethics Committee of Shiraz University of Medical Sciences (IR.SUMS.MED.REC.1403.494), All methods were performed in accordance with the relevant guidelines and regulations (Declaration of Helsinki) the requirement for informed patient consent was waived due to the study’s retrospective design. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patient Flowchart
Fig. 2
Fig. 2
Optos fundus photograph (A), fundus autofluorescence (B), fluorescein angiography (C), and macular OCT before (D) and after (E) treatment in patient treated with half-dose PDT. The complete resolution of foveal subretinal fluid after PDT is evident
Fig. 3
Fig. 3
Optos fundus photograph (A), fundus autofluorescence (B), fluorescein angiography (C), and macular OCT before (D) and after (E) treatment in patient treated with one-third-dose PDT. The near complete resolution of foveal subretinal fluid after PDT is evident
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