Photodynamic Therapy of Bullous Central Serous Chorioretinopathy with Subretinal Exudate and a Tear of the Retinal Pigment Epithelium

Purpose: To report a case of bullous central serous chorioretinopathy associated with subretinal exudates and a tear of the retinal pigment epithelium imaged using spectral domain optical coherence tomography and treated successfully with reduced fluence verteporfin photodynamic therapy.

Patients: Observational case report.

Methods: Patient with central serous chorioretinopathy and associated subretinal exudates was imaged using spectral domain optical coherence tomography and managed using photodynamic therapy.

Results: The patient was treated unsuccessfully with intravitreal bevacizumab and ranibizumab followed by successful treatment with reduced fluence photodynamic therapy. Spectral domain optical coherence tomography imaging of the lesion identified the subretinal exudates and a retinal pigment epithelium tear before treatment.

Conclusion: In this case of severe bullous central serous chorioretinopathy, spectral domain optical coherence tomography identified a tear of the retinal pigment epithelium not previously identified using clinical exam or time domain optical coherence tomography. The lesion was successfully treated using reduced fluence photodynamic therapy after intravitreal antivascular endothelial growth factor drugs had no effect.