Efficacy of Photodynamic Therapy in Chronic Central Serous Chorioretinopathy: A Retrospective Analysis at Hanusch Hospital, Vienna

Abstract: BACKGROUND: Chronic central serous chorioretinopathy (cCSC) is an exudative maculopathy characterised by persistent subretinal fluid and potential visual deterioration. Photodynamic therapy (PDT) with verteporfin is an established treatment option, particularly in refractory or chronic cases. This retrospective, single centre study aimed to evaluate the functional and morphological efficacy of PDT in patients with cCSC at Hanusch Hospital, Vienna. Abstract: PATIENTS/MATERIALS AND METHODS: We analysed 49 eyes of 38 patients who underwent PDT between 2020 and 2025. Best-corrected visual acuity (decimal), central retinal thickness (CRT, µm), and subretinal fluid (SRF, µm) were assessed using spectral domain OCT before and after treatment. Statistical analyses included the Shapiro-Wilk test for normality and the Wilcoxon signed-rank test for paired samples. Subgroup analyses were conducted for repeat PDT (Re-PDT) and secondary choroidal neovascularisation (CNV). Abstract: RESULTS: Overall, PDT led to a significant improvement in visual acuity (p = 0.041) and a highly significant reduction in both CRT and SRF (each p < 0.001). In the Re-PDT subgroup (n = 6), significant morphological improvement (p = 0.028 for CRT and SRF) was observed without a statistically significant gain in vision (p = 0.109). No significant therapeutic effect was found in patients with secondary CNV. There was a significant negative correlation between visual acuity and CRT (r = - 0.42; p = 0.005) and between visual acuity and SRF (r = - 0.37; p = 0.012). Abstract: CONCLUSION: PDT appears to be an effective treatment for achieving anatomical and functional stabilisation in cCSC. The limited visual improvement in Re-PDT and CNV subgroups underscores the importance of early treatment and tailored decision-making in cases of secondary neovascularisation.