✅ Medically reviewed by Dr Sharon Heng

Central Serous Retinopathy (CSR) is a condition that affects the macular, causing fluid buildup underneath it. This leads to vision impairment, often described as blurry or distorted. In majority of cases, the condition is self resolving, more persistent or recurrent cases may require treatment.
One such treatment is Photodynamic Therapy (PDT). Understanding what PDT entails and how it works can help patients prepare for the process and set appropriate expectations for recovery.
What Is Central Serous Retinopathy?
Central Serous Retinopathy occurs when fluid accumulates underneath the macula, the light-sensitive tissue at the back of the eye. This happens due to leakage from the choroid, the layer of blood vessels beneath the retina. There is a single layer of cells called the retina pigment epithelium that is between retina and choroid which works as a ‘pump’ and when it does not function, fluid then builds up beneath the retina, causing decline in vision or distortion.
The exact cause of CSR is still unclear, but stress and steroid use are commonly associated with it. Individuals with CSR often experience blurry or distorted central vision, making everyday activities like reading or driving difficult.
CSR typically affects one eye, although it can occur in both eyes. In many cases, the fluid buildup resolves without intervention. However, if the condition persists or recurs frequently, treatments such as PDT or retina laser may be necessary to restore proper retinal function.
How Photodynamic Therapy (PDT) Works
Photodynamic Therapy, commonly referred to as PDT, is a treatment that uses a combination of photosensitive dye and a targeted light source which transforms light into chemical energy, resulting in the release of free radicals causing site-specific vascular occlusion with targeted cellular destruction.
During PDT, a light-sensitive drug called verteporfin is injected into the patient’s bloodstream.
Once the drug circulates to the eye, a specific laser wavelength is applied to the affected area of the retina. This activates the verteporfin, which helps seal the leaking blood vessels and reduce fluid buildup.
PDT has been successfully used to treat various retinal conditions, including CSR, due to its precision and minimal damage to surrounding tissues. Unlike traditional laser treatments, which can cause damage to the retina, PDT is designed to target only the problematic blood vessels while preserving the overall health of the retina.
What to Expect During PDT Treatment
When undergoing private retina laser therapy like PDT, patients can expect a straightforward, outpatient procedure. The entire process typically takes about 20-30 minutes. Below is an overview of what to expect:
Pre-Treatment Preparation: Before the procedure, the doctor will assess the severity of the CSR and determine if PDT is the appropriate course of action. You will receive a comprehensive eye examination, including imaging tests such as optical coherence tomography (OCT) or fluorescein angiography and indocyanine angiography, to evaluate the fluid buildup in the retina.
Drug Administration: Once you are prepared for the treatment, verteporfin will be injected into a vein, usually in your arm. This drug is designed to travel to the affected blood vessels in your eye.
Laser Activation: After the drug has circulated through your body (approximately 10-15 minutes), the doctor will direct a low-intensity laser at the retina. The light activates the verteporfin, which helps close off the leaking vessels.
Post-Treatment Care: Following PDT, patients are advised to avoid direct sunlight or bright indoor lighting for at least 48 hours, as the verteporfin remains in your body and can be activated by exposure to light. Sunglasses and protective clothing are recommended during this period. Your doctor may also prescribe anti-inflammatory medications to reduce any discomfort or swelling.
Recovery and Results
While PDT is a minimally invasive procedure, recovery can vary depending on the individual and the severity of the condition. In most cases, patients can resume their normal activities within a few days, but it is crucial to adhere to post-treatment guidelines, particularly avoiding light exposure.
You may experience some temporary vision changes, such as blurriness or light sensitivity, but these typically resolve within a few days to a week. The success of private retina laser therapy like PDT for treating CSR can also vary. Many patients see a significant improvement in their vision as the fluid under the retina reabsorbs.
However, it is important to understand that PDT may not completely restore vision to its previous state, especially in cases where the retina has been damaged for a prolonged period. Follow-up appointments are essential to monitor the condition and ensure that the retina is healing as expected.
Risks and Potential Side Effects
As with any medical procedure, there are some risks associated with PDT. While rare, complications can include:
Vision Changes: Some patients may experience temporary changes in vision, such as blurred vision or decreased night vision. These effects are usually short-lived, but it’s essential to report any persistent or worsening symptoms to your doctor.
Light Sensitivity: Due to the photosensitive nature of the verteporfin drug, some patients may develop extreme sensitivity to light, which can last for several days after the procedure. Avoiding sunlight and bright artificial light is critical during this time.
Inflammation or Swelling: In some cases, the laser treatment can cause mild inflammation or swelling in the retina. Your doctor may prescribe medication to alleviate these symptoms if they arise.
Secondary choroidal neovascularisation (CNV): This is very rare and mainly reported in patients who have full dose of verteporfin and full fluence laser settings. The usual practice now is half dose of verteporfin or half fluence or both. CNV can be treated with anti VEGF therapy when and if it occurs.
Despite these risks, PDT is generally considered a safe and effective treatment option for managing CSR. Discussing any concerns or potential side effects with your healthcare provider can help ensure a smooth treatment experience.
Is PDT Right for You?
PDT is not the first line of treatment for all CSR cases. Many patients with mild symptoms or early-stage CSR may find that their condition improves without intervention. However, for those who experience recurrent episodes or prolonged fluid buildup, PDT offers a viable solution.
Consulting a retina specialist is the best way to determine whether private retina laser therapy is the right choice for your condition.
Are There Other Treatment Options?
Depending on the area of leakage , a micropulse laser may also be an effective treatment option. In patients who have CNV as a complication of chronic CSR itself, anti VEGF will be the preferred therapeutic option.
Conclusion
Central Serous Retinopathy can be a disruptive condition that impacts your vision and daily activities. While many cases resolve without treatment, those that persist may require interventions like Photodynamic Therapy to address the underlying cause of fluid leakage.
PDT offers a targeted, minimally invasive approach, helping patients regain their vision and improve their quality of life. If you’re experiencing ongoing CSR symptoms, consulting with a specialist for private retina laser therapy can help determine the best treatment plan for your needs.
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