Photodynamic Therapy (PDT)

Central serous retinopathy (CSR) is an eye condition that develops when fluid collects beneath the retina and usually affects the central area of vision (the macula). Although it is seen more frequently in men aged 20–50, it can occur in any age group. Stress, cortisone use and certain lifestyle factors play an important role in the development of CSR.

Photodynamic therapy (PDT) is one of the modern treatment methods used particularly in chronic cases of CSR.

What Is CSR (Central Serous Retinopathy)?

Central serous retinopathy is characterised by the accumulation of fluid in the macular region caused by small leaks that occur in the retinal pigment epithelium layer.

This condition leads to blurring and distortion in the centre of vision and a marked decline in visual quality.

Symptoms of CSR

• Blurred vision
• Straight lines appearing curved or wavy
• Dark or shadowed areas within the field of vision
• Disturbance in colour perception
• Sudden loss or reduction of vision

Causes of CSR

Although its exact cause is not fully known, the following factors play a role in the development of CSR:

• Intense stress
• Cortisone use (in the form of medication, cream or spray)
• Hypertension (high blood pressure)
• Irregular sleep and fatigue
• Genetic predisposition
• Hormonal changes

How Is CSR Diagnosed?

The main methods used in diagnosis:

• Optical Coherence Tomography (OCT): Clearly shows the presence of fluid beneath the retina.
• Fluorescein Angiography: Images the leakage in the retinal vessels.
• Eye examination: Signs of the condition are assessed with visual acuity tests.

Treatment Methods for CSR

Some cases of CSR may resolve on their own. However, treatment is needed in cases that persist for a long time or that recur.

1. Medication

In some cases, fluid absorption can be accelerated with medication given orally or intravenously.

2. Laser Treatment

Low-dose laser applied to the area of leakage can help prevent fluid accumulation.

3. Photodynamic Therapy (PDT)

This is one of the methods used in the treatment of chronic CSR.

What Is Photodynamic Therapy (PDT)?

Photodynamic therapy is a special laser treatment used to seal the leakage beneath the retina in CSR.

• Before treatment, a light-sensitive medication called verteporfin is given through a vein.
• The affected blood vessel area is then targeted with low-energy laser light.
• The interaction between the medication and the laser light stops the vascular leakage.

Advantages of Photodynamic Therapy

• Can be applied in a targeted manner in chronic cases of CSR
• Does not harm the surrounding healthy tissue
• May contribute to improvement in visual quality
• Is intended to help reduce the risk of recurrence

The Process After Photodynamic Therapy

• The treatment usually takes 15–20 minutes.
• The patient can usually be discharged on the same day.
• Protection from sunlight is necessary for the first few days (because the medication is light-sensitive).
• Vision gradually begins to improve over the course of a few weeks.

Central serous retinopathy (CSR) is a condition that seriously affects visual quality but can be brought under control with early diagnosis and appropriate treatment. Photodynamic therapy (PDT) is considered one of the methods used in the treatment of chronic CSR.