Central Serous Chorioretinopathy: Multimodal Imaging and Management Options

Figure 12

Chronic central serous chorioretinopathy of the left eye treated with both thermal laser photocoagulation and half fluence photodynamic therapy (PDT). A 42-year old female presented with blurred vision for two years. (a–d) Images at baseline. (a) Fundus photography showed pigmentary changes around a pigment epithelial detachment (PED). (b) Early-phase fluorescein angiography (FA) showed leakage in the fovea as well as slightly superotemporal. (c) Late-phase FA showed increased leakage; the superotemporal lesion is noted by the yellow arrow. (d) Optical coherence tomography (OCT) showed a large subfoveal PED. The patient was initially treated with thermal photocoagulation to the superotemporal lesion (yellow arrow in (c)), so as to spare the fovea. (e) Following thermal photocoagulation, the clinical appearance did not change. (f) Early-phase FA and (g) late-phase FA showed improvement of the treated superotemporal lesion but persistent leakage of the untreated subfoveal PED. (h) OCT showed no change in the subfoveal PED (noted by the blue arrow in (g)). The patient then underwent half-fluence PDT (blue arrow in (g)). (i) One month later, OCT showed resolution of the pigment epithelial defect. Visual acuity improved from 20/30 to 20/20.

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