Photodynamic therapy and anti-vascular endothelial growth factor for acute central serous chorioretinopathy: An updated systematic review and meta-analysis.
Hamzah Saad Algodi, Salem Abu Al-Burak, Eric Zeng et al.
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In 30 seconds
This PRISMA-compliant systematic review and meta-analysis compared photodynamic therapy (PDT) and anti-vascular endothelial growth factor (anti-VEGF) treatment with observation for acute central serous chorioretinopathy (CSC) lasting less than 6 months. Eleven comparative studies—5 randomized and 6 non-randomized—included 464 eyes. PDT was associated with better visual acuity and sustained reductions in central macular thickness, and treated eyes were nearly 4 times more likely to achieve complete fluid resolution at 1 month. Anti-VEGF showed only a transient anatomical benefit, without significant visual improvement or sustained effect.
Key findings
- PDT-treated eyes were nearly 4 times more likely than observed eyes to achieve complete fluid resolution at 1 month; the benefit persisted across follow-up intervals.
- PDT was associated with significant best-corrected visual acuity gains and sustained central macular thickness reductions at 1, 3, and 12 months.
- Anti-VEGF produced a transient anatomical reduction at 1 month, without significant visual improvement or sustained benefit.
- Both interventions were reported as well tolerated.
Why it matters
Acute CSC can resolve spontaneously, but persistent fluid may be associated with progression to chronic disease and visual impairment. The review suggests PDT can accelerate fluid resolution while providing sustained anatomical and functional improvement, whereas anti-VEGF has limited, transient anatomical effects. These comparative findings help frame treatment discussions around the potential benefits of intervention and the validity of observation.
What to keep in mind
The evidence combines 11 studies, including 6 non-randomized studies, so findings are not based solely on randomized comparisons.