Three-Year Results of Fluorescein Angiography-Guided Standard Photodynamic Therapy with Multiple Spots for Central Serous Chorioretinopathy.

PURPOSE: To report the long-term results of fluorescein angiography (FA)-guided standard photodynamic therapy (PDT) for central serous chorioretinopathy (CSCR) and its adverse effects. DESIGN: Prospective, noncomparative, interventional study. PARTICIPANTS: Consecutive patients (N = 63 eyes) with acute (39 eyes) or chronic (24 eyes) CSCR. METHODS: All eyes underwent FA-guided conventional PDT, using multiple spots in 1 session if appropriate, and were assessed before PDT, as well as at months 3, 6, and 12 after PDT, and every 6 months thereafter until the end of the 3-year follow-up time. MAIN OUTCOME MEASURES: Primary outcome measures were the resolution of subretinal fluid (SRF) and the improvement of the Snellen best-corrected visual acuity (BCVA) to better than 20/100 at the end of the study. Secondary outcomes were the changes in mean BCVA and central foveal thickness (CFT) during the follow-up time. RESULTS: All 63 eyes with acute or chronic CSCR demonstrated complete resolution of SRF at the end of the study. Of the studied eyes, 51 (80.95%) underwent a single PDT application. The mean CFT improved significantly at all time points in the acute CSCR group (P < 0.001) from 515.13±110.5 µm to 297.75±22.3 µm at 3 years and in the chronic CSCR group from 484.12±62.49 µm to 293.81±16.89 µm. At 3 years, a gain of more than 20/100 in Snellen BCVA was seen in 28 acute and 16 chronic CSCR PDT-treated eyes (71.8% vs. 66.67%; P = 0.779). The mean logarithm of the minimum angle of resolution BCVA improved from 0.349±0.18 at baseline to 0.060±0.06 at the end of the study (P < 0.001) for eyes with acute CSCR and from 0.502±0.28 to 0.198±0.11 correspondingly for the eyes with chronic CSCR (P < 0.001). None of the study eyes demonstrated any serious systemic or ophthalmologic complication related to the use of the standard PDT with verteporfin. CONCLUSIONS: Fluorescein angiography-guided conventional PDT achieved outcomes for acute and chronic CSCR comparable with those reported with modified PDT techniques. We did not identify new safety concerns.

CAPILLARY NONPERFUSION AND PHOTORECEPTOR LOSS IN BRANCH RETINAL VEIN OCCLUSION: Spatial Correlation and Morphologic Characteristics.

PURPOSE: To evaluate the photoreceptor layer in eyes with branch retinal vein occlusion associated with macular ischemia, using a method of en face optical coherence tomography (OCT) representation of the ellipsoid zone. METHODS: Customized macular OCT scans of 9 patients (10 eyes) with branch retinal vein occlusion and macular ischemia were exported and subsequently postprocessed (removal of vascular and cystic spaces' shadows, segmentation, and alignment to the retinal pigment epithelium). The ellipsoid band was then isolated, aligned, and used to produce an en face OCT image. Areas with photoreceptor loss (hyporeflective ellipsoid) were compared with ischemic areas as identified in an early-phase fluorescein angiography. RESULTS: The areas of capillary nonperfusion (as detected in fluorescein angiography) were closely associated with disruption of the ellipsoid zone (depicted as areas of low reflectance in the en face reconstruction of the OCT images). The ellipsoid zone disruption had a patchy appearance and either sharp or fuzzy borders, depending on the grade of the loss of reflectance. CONCLUSION: En face OCT reconstruction and subsequent representation of ellipsoid zone revealed a close association between capillary nonperfusion and photoreceptor disruption in eyes with branch retinal vein occlusion. It seems that the deep capillary plexus plays an important role on the metabolic demands of outer retina and, consequently, an ischemia at the level of deep capillary plexus has significant impact on the integrity of the photoreceptors.

Multiple spots of photodynamic therapy for the treatment of severe chronic central serous chorioretinopathy.

PURPOSE: To evaluate the efficacy and safety of fluorescein angiography (FA)-guided photodynamic therapy (PDT) for the treatment of severe chronic central serous chorioretinopathy (CSC). METHODS: Patients presenting with chronic CSC with multiple areas of retinal pigment epithelium decompensation, with or without focal leaks, were treated with FA-guided full-fluence PDT. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), FA, indocyanine green angiography, and fundus autofluorescence were used to determine functional and anatomic outcomes. RESULTS: Twenty-one eyes (17 patients) were treated with PDT and followed for a median of 24 months (range, 12-73). In fourteen eyes (66.66%), two PDT spots were performed within the same session. In three eyes (14.28%), three PDT spots were performed, in two eyes (9.52%) four spots, and in two eyes (9.52%) five spots. In 17 eyes (80.95%), the leakage in FA and the subretinal fluid in OCT disappeared after only one session of PDT. In four eyes (19.05%), a second session - with only one spot - of PDT was required due to persistent or recurrent leakage and subfoveal SRF. Median BCVA improved significantly from 20/63 at baseline to 20/40 at 3 months (P = 0.0002) and 20/32 at 6 months (P < 0.0001), and remained improved until the last examination (20/25, P < 0.0001). Two patients complained of a transient central scotoma after the treatment. CONCLUSION: FA-guided full-fluence PDT with multiple PDT spots within the same session seems to be effective and safe for the treatment of chronic CSC cases with multiple areas of retinal pigment epithelium decompensation.

Intravitreal ranibizumab versus thermal laser photocoagulation in the treatment of extrafoveal classic choroidal neovascularization secondary to age-related macular degeneration.

BACKGROUND: To compare the efficacy of thermal laser photocoagulation versus intravitreal ranibizumab for the treatment of extrafoveal classic choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). METHODS: We conducted a retrospective study on 24 eyes with extrafoveal classic CNV secondary to AMD, treated either with thermal laser photocoagulation (group 1) or with intravitreal ranibizumab (group 2). Visual acuity, number of injections/sessions and recurrence rate were assessed. RESULTS: The mean follow-up time was 23.6 ± 2.26 and 19.1 ± 9.74 months for group 1 and 2, respectively. Mean best corrected visual acuity (BCVA) of groups 1 and 2 was 0.59 ± 0.32 and 0.46 ± 0.30 logMAR, respectively (p = 0.343). At the end of the follow-up, mean BCVA of group 1 was 0.92 ± 0.35 and of group 2 0.16 ± 0.12 logMAR and differed statistically compared to baseline (p = 0.02 and p = 0.006, respectively). There was a statistically significant difference between the two groups as far as BCVA at the end of the follow-up was concerned (p < 0.0001). The patients in group 1 received on average 1.38 sessions of thermal laser photocoagulation, while patients in group 2 received on average 4 injections of ranibizumab. The recurrence rate in the laser group was 84.6%, while in the ranibizumab group it was 18.2% (p < 0.001). Specifically, the mean time of recurrence in the laser group was 11.5 months, whereas in the ranibizumab group it was 18 months (p = 0.048). CONCLUSION: Intravitreal ranibizumab showed promising results in BCVA improvement and decrease in macular thickness in patients with extrafoveal classic CNV due to AMD, with a small number of injections. Laser photocoagulation treatment presented worsening in BCVA and high recurrence rate in our study with long-term follow-up.

Long-term results of intravitreal ranibizumab, intravitreal ranibizumab with photodynamic therapy, and intravitreal triamcinolone with photodynamic therapy for the treatment of retinal angiomatous proliferation.

PURPOSE: To compare intravitreal ranibizumab, intravitreal ranibizumab plus photodynamic therapy (PDT), and intravitreal triamcinolone plus PDT in retinal angiomatous proliferation, presenting the results of a 3-year follow-up. METHODS: Thirty-seven eyes of 37 patients with retinal angiomatous proliferation were randomized to 1 of the 3 groups. Group 1 (n = 13) received 3 monthly injections of 0.5 mg ranibizumab, Group 2 (n = 13) received 1 session of PDT and 3 monthly injections of ranibizumab, and Group 3 (n = 11) received 1 session of PDT and 1 injection of 4 mg triamcinolone. Retreatment, with the same therapeutic scheme in each group, was considered in case of persistence or recurrence of subretinal/intraretinal fluid. RESULTS: Twelve patients in Groups 1 and 2 and 9 patients in Group 3 completed the 3-year follow-up. A total of 58% of patients in Group 1, 50% in Group 2, and 88.9% in Group 3 had the same or better visual acuity at the end of the follow-up (P = 0.081). Patients in Group 3 exhibited considerable improvement in visual acuity (P = 0.032) and statistically significant decrease in central retinal thickness (P < 0.0001) than the 2 other groups at the end of the follow-up. Also, the patients in Group 3 received on average the lowest number of injections (P < 0.0001). Of note, geographic atrophy mainly at the place of previous retinal angiomatous proliferation lesion was detected in 0% in Group 1, 25% in Group 2, and 55.6% in Group 3 (P = 0.203), while 33.3% of patients in Group 1 developed retinal scar. CONCLUSION: Treatment with ranibizumab or ranibizumab plus PDT resulted in stabilization of the disease, while treatment with IVT plus PDT achieved better results in terms of functional and anatomical features compared with the other groups.

Atypical unilateral maculopathy associated with acute exudative polymorphous vitelliform maculopathy-like yellowish deposits.

PURPOSE: To report a case of atypical unilateral maculopathy associated with acute exudative polymorphous vitelliform maculopathy-like yellowish deposits. METHODS: Observational case report of one patient. RESULTS: A 52-year-old man presented with reduced vision in the left eye. Findings resembling acute exudative polymorphous vitelliform maculopathy were noted with ophthalmoscopy, fluorescein angiography, and optical coherence tomography. Funduscopic examination revealed an exudative macular detachment with yellowish subretinal deposits inferior to the fovea. On fluorescein angiography, the perifoveal lesions were minimally hyperfluorescent, with no abnormal fluorescence in the central macula. The subretinal deposits were found to be hyperautofluorescent on fundus autofluorescence imaging. Optical coherence tomography confirmed a serous detachment of the retina with intraretinal cystic spaces. The right eye did not show any abnormalities except for an epiretinal membrane. CONCLUSION: We describe a case of atypical unilateral maculopathy associated with acute exudative polymorphous vitelliform maculopathy-like yellowish deposits.

Ranibizumab for the treatment of exudative age-related macular degeneration associated with retinal pigment epithelial tear.

PURPOSE: To evaluate the efficacy of intravitreal ranibizumab in eyes with exudative age-related macular degeneration associated with retinal pigment epithelial tear. METHODS: In this retrospective case series, patients with active exudative age-related macular degeneration associated with retinal pigment epithelial tear were treated by repeated injections of intravitreal ranibizumab. The outcome measures were best-corrected visual acuity and the signs of lesion activity, as evaluated by optical coherence tomography, fluorescein angiography, and indocyanine green angiography. RESULTS: Twenty-one eyes of 20 patients were followed-up for a median of 12 months (range, 6-28 months). The median number of injections was 7 (range, 3-15). The best-corrected visual acuity improved in 6 eyes (28.57%), remained stable in 12 (57.14%), and decreased in 3 (14.28%). At the end of the follow-up time, 19 eyes (90.47%) had an inactive neovascular lesion in angiography, while 18 eyes (85.71%) had no signs of intraretinal or subretinal fluid. CONCLUSION: Intravitreal ranibizumab was effective in improving or stabilizing vision and resulting in a quiescent lesion in the majority of patients with exudative age-related macular degeneration associated with retinal pigment epithelial tear. The functional results were apparently better in eyes without foveal involvement by the retinal pigment epithelial tear.

Ranibizumab for diabetic macular edema difficult to treat with focal/grid laser.

BACKGROUND: To evaluate the efficacy of intravitreal injections of ranibizumab in patients with diabetic clinically significant macular edema (CSME), when further focal or grid laser was considered to be unsafe. METHODS: In this retrospective, interventional case study, intravitreal injections of ranibizumab were performed in 16 eyes (ten patients) suffering from diabetic retinopathy with CSME. All patients had been treated in the past with focal or grid laser. Additional photocoagulation could not be performed because the leaking points were very close to the avascular zone, and there was also a perifoveal capillary dropout. The patients underwent three injections (months 0, 1 and 2) and were followed monthly. Reinjection was performed if central retinal thickness (CRT) was ≥250 µm associated with fluorescein leakage involving the center of the macula. RESULTS: The patients underwent a median of seven injections (range 6-9) and the median follow-up time was 11 months (range 9-15). The median best-corrected visual acuity (BCVA) was 0.85 logMAR at baseline and 0.54 logMAR at the end of the follow-up time (p = 0.018). BCVA improved in seven eyes (43.75%), remained stable in eight (50%) and decreased in one eye (6.25%). The median CRT decreased from 409.5 µm at baseline to 272 µm at the end of the follow-up time (p = 0.0002). No ocular or systemic adverse events were reported. CONCLUSIONS: For a median follow-up time of 11 months, the treatment with intravitreal injections of ranibizumab resulted in stabilization or improvement of the visual acuity in the vast majority of patients with diabetic maculopathy and CSME, when further focal or grid laser was considered to be unsafe.

Intravitreal ranibizumab treatment of macular choroidal neovascularization secondary to angioid streaks: one-year results of a prospective study.

PURPOSE: The purpose of this study was to evaluate the efficacy of intravitreal ranibizumab in eyes with macular choroidal neovascularization secondary to angioid streaks. METHODS: A prospective interventional case series was conducted on eyes with macular choroidal neovascularization, secondary to angioid streaks, treated by repeated injections of intravitreal ranibizumab (0.5 mg) and completing a follow-up time of 1 year. The outcome measures were best-corrected visual acuity, greatest lesion height as evaluated by optical coherence tomography, and lesion size as assessed by fluorescein angiography. RESULTS: Over a 16-month period, we treated 15 consecutive eyes. The average number of injections was 7.1 +/- 0.5. Mean best-corrected visual acuity was improved from 20/100 to 20/50 (P = 0.006). Best-corrected visual acuity either improved or stabilized in 14 eyes (93.3%). At baseline, 3 of the 15 eyes (20%) had a best-corrected visual acuity of >or=20/50 compared with 10 eyes (66.7%) at the end of the first year. Fourteen eyes (93.3%) presented reduction in greatest lesion height and stabilization or reduction in lesion size. The mean greatest lesion height was decreased from 377.3 +/- 139.7 microm to 270.2 +/- 88.6 microm (P < 0.001). CONCLUSION: Intravitreal ranibizumab is highly effective in improving or stabilizing vision and lesion morphology in patients with macular choroidal neovascularization secondary to angioid streaks.

Fluorescein angiography and optical coherence tomography concordance for choroidal neovascularisation in multifocal choroidtis.

PURPOSE: To compare the utility of fluorescein angiography (FA) and optical coherence tomography (OCT) as diagnostic adjuncts in evaluating symptomatic patients with choroidal neovascularisation (CNV) due to multifocal choroiditis (MFC). METHODS: Patients with CNV due to MFC were retrospectively evaluated in a consecutive fashion. Fundus photography, FA, OCT and biomicroscopy were used to establish the diagnosis. Primary outcome measures included CNV classification (type 1 or occult and type 2 or classic) location and the associated FA and OCT findings. RESULTS: Twenty eyes from 17 patients were included in the study. In 19 eyes (95%) the FA revealed CNV type 2; in one eye (5%) the type of CNV was indeterminate due to a subretinal haemorrhage that covered the lesion. Thirteen eyes had OCT imaging and all revealed hyper-reflectance beneath the neurosensory retina. However, only 53.8% revealed subretinal fluid (SRF) or intraretinal cystic abnormalities. CONCLUSIONS: The CNV in MFC is virtually always type 2, or so-called classic CNV, with vessels beneath the neurosensory retina. Except when blocked by subretinal blood, the neovascularisation is clearly demonstrated by FA. In contrast, only 53.8% of these eyes showed clear evidence of actively proliferating neovascularisation on OCT. Therefore, eyes suspected of having CNV in MFC should be evaluated with FA.

Photodynamic therapy of choroidal neovascularization with enlargement of the spot size to include the feeding complex.

This is a case report of a 83-year-old man with choroidal neovascularization (CNV), due to age-related macular degeneration (AMD) in his right eye. Digital fluorescein (FA) and indocyanine green angiography (ICG) were performed, which disclosed predominantly classic subfoveal CNV and a dilated and tortuous feeding complex. The visual acuity was 20/800. Anti-vascular endothelial growth factor (anti-VEGF) treatment was suggested, however, the patient was not keen to receive an intraocular injection. Modified photodynamic therapy (PDT) with spot size enlarged, to include not only the CNV lesion but the feeding complex as well, was performed. Ten days after one session of PDT, ICG showed absence of leakage from the CNV and complete occlusion of the feeding complex. The visual acuity gradually improved to 20/100 and remained stable during the following 23 months. No evidence of CNV leakage was seen in the FA and ICG during the follow up period. Adjustment of the PDT spot size to include the detectable by ICG feeding complex might be an additional option in order to close the subfoveal CNV and might be considered as an alternative to intravitreal injection of anti-VEGF in selected cases where anti-VEGF treatment is not available.

Skin rash associated with intravitreal bevacizumab in a patient with macular choroidal neovascularization.

PURPOSE: The purpose of this observational case report is to describe a case of skin rash after intravitreal use of bevacizumab. METHODS: A 50-year-old man with choroidal neovascularization in the right eye due to age-related macular degeneration was treated with three intravitreal injections of bevacizumab. RESULTS: Twelve days after the first injection, the patient developed a maculopapular rash on his forehead and on both temporal regions around his eyes. The rash disappeared eight days after treatment with topical corticosteroids. A skin rash with the same distribution reappeared 14 days after the second and 10 days after the third injection. Similarly, it disappeared five and seven days after the use of the same treatment. The follow-up period was 15 months after the third injection. During the follow-up period the rash did not reappear. CONCLUSION: This case report may initiate further investigation of similar cases to support this observation, as there are a lack of reports of skin rash after intravitreal administration of bevacizumab.

Safety of repeat intravitreal injections of bevacizumab versus ranibizumab: our experience after 2,000 injections.

PURPOSE: To compare the safety of repeat intravitreal injections of bevacizumab versus ranibizumab performed on a large series of patients during the past 2 years period of time. METHODS: Four hundred fifty patients receiving 2,000 injections (1,275 bevacizumab and 725 ranibizumab) were studied retrospectively. Injections performed in a usual examination room under the standard sterile conditions. Follow-up varied from 3 to 24 months. RESULTS: Serious ocular adverse events were uncommon. Only one patient developed retinal detachment (0.05%). Most common procedure-related ocular adverse event was injection-site redness (64.75%). Postoperative subconjuctival hemorrhage occurred after 200 (10%) injections. Patients receiving aspirin treatment were more prone to have subconjuctival hemorrhage (P = 0.0002). Most common drug-related ocular adverse event was uveitis (1.90%), which was treated successfully and lasted no >12 days. There was no statistically significant difference between the patients treated with bevacizumab or ranibizumab regarding the noted adverse events (P > 0.5%). CONCLUSION: Multiple intravitreal injections of bevacizumab or ranibizumab were both well tolerated and safe. Performing injections on a usual examination room proved safe. Injection-site redness, subconjuctival hemorrhage, and uveitis were the most common ocular adverse events. Aspirin treatment was a risk factor for the development of subconjuctival hemorrhage.

Vitreomacular adhesion in active and end-stage age-related macular degeneration.

PURPOSE: To evaluate vitreomacular relations in different stages of age-related macular degeneration (AMD) without the influence of genetics and environmental factors. DESIGN: Retrospective, observational case series. METHODS: This was a multicenter study consisting of 29 previously untreated subjects with active exudative (wet) AMD in one eye and active nonexudative (dry) AMD in the fellow eye who were compared with 10 previously untreated subjects with end-stage geographic atrophy in one eye and an end-stage fibrotic (disciform) scar in the fellow eye. All subjects were studied with ultrasonography to identify the presence of posterior vitreous detachment (PVD) and by optical coherence tomography to detect vitreomacular adhesion (VMA). RESULTS: The incidence of PVD in eyes with nonexudative AMD was 20 (69%) of 29, compared with 6 (21%) of 29 with active exudative AMD (P = .002). VMA was present in 11 (38%) of 29 of eyes with exudative AMD and in only 3 (10%) of 29 eyes with nonexudative AMD (P = .008). The incidence of PVD in geographic atrophy was 7 (70%) of 10, compared with 4 (40%) of 10 with disciform scar (P = .44). VMA was present in 2 (20%) of 10 eyes with disciform scars and in 0 (0%) of 10 eyes with geographic atrophy (P = .48). CONCLUSIONS: PVD may protect against exudative AMD, whereas VMA may promote exudative AMD. This phenomenon is not evident in end-stage disease because of an increased incidence of PVD and a decreased incidence of VMA in eyes with disciform scars. Genetic and environmental factors do not seem to influence these observations.

Retinal vein occlusion and papillitis in serpiginous choroidopathy.

BACKGROUND: Inflammation of the optic nerve associated with central retinal vein occlusion is a well-documented disorder known as papillophlebitis, which occurs in young adults. PURPOSE: To report two cases of serpiginous choroidopathy complicated by retinal vein occlusion in association with papillitis. METHODS: Two patients with serpiginous choroidopathy were examined during their acute and follow-up periods. RESULTS: One patient developed a central retinal vein occlusion and the other a branch retinal vein occlusion. In both cases, the occlusion was associated with segmental edema of the optic nerve (papillitis). CONCLUSION: Serpiginous choroidopathy may rarely be complicated by retinal vein occlusion from papillitis.

Solitary idiopathic choroiditis with choroidal neovascularization.

PURPOSE: To report a case of solitary idiopathic choroiditis associated with choroidal neovascularization. METHOD: Case report of a 36-year-old healthy man who was referred for floaters in the left eye of 3 weeks' duration. RESULTS: Fundus examination of the left eye revealed a yellow-white subretinal lesion superior to the fovea. It was associated with a small subretinal hemorrhage and a macular detachment, which extended into the fovea. No vitreous cells were detected. The right eye was normal. The visual acuity was 20/20 in the right eye and 20/50 in the left eye. Laboratory evaluation for inflammatory or infectious diseases was nonrevealing. Fluorescein angiography showed Type 2 or so-called classic choroidal neovascularization associated with retinochoroidal anastomoses. After two laser treatments with poor outcomes, the lesion was effectively treated with oral steroids. A reactivation occurred 1.5 years later, and it was also successfully treated with oral steroids. CONCLUSION: Solitary idiopathic choroiditis can rarely be associated with choroidal neovascularization. Oral steroid treatment seems to be the preferred form of therapy rather than some form of interventional modality.

Intravitreal bevacizumab combined with photodynamic therapy for the treatment of occult choroidal neovascularization associated with serous pigment epithelium detachment in age-related macular degeneration.

PURPOSE: To evaluate the efficacy of intravitreal injection of bevacizumab combined with photodynamic therapy (PDT) for the treatment of occult choroidal neovascularization (CNV) associated with serous pigment epithelium detachment (s-PED) due to age-related macular degeneration (AMD). METHODS: In this retrospective study, six patients (six eyes) with subfoveal occult CNV associated with s-PED due to AMD were treated with intravitreal bevacizumab combined with PDT. All patients were treated at baseline with PDT followed by intravitreal bevacizumab 1.25 mg 1 hour later. Afterwards, according to the findings of optical coherence tomography and fluorescein angiography, repeat bevacizumab injections were given, if necessary, monthly for three doses followed by further doses every 3 months. PDT was repeated every 3 months according to the same criteria. Follow-up time was 9 months. RESULTS: All patients completed their treatment during the first 3 months from baseline. Best-corrected visual acuity (BCVA) improved or remained stable related to the baseline values in all patients at the end of the follow-up time. Mean BCVA improved from 20/67 to 20/42. S-PED and subretinal fluid decreased or disappeared. The mean central 1-mm retinal thickness was reduced from baseline value for the 9-month follow-up period by 128 microm. CONCLUSION: Intravitreal bevacizumab combined with PDT seems to be a promising treatment with good functional and anatomical results for occult CNV associated with s-PED due to AMD.

Efficacy of photodynamic therapy in the management of occult choroidal neovascularization associated with serous pigment epithelium detachment.

AIMS: To evaluate the efficacy of photodynamic therapy (PDT) in the treatment of subfoveal occult choroidal neovascularization (CNV) associated with serous pigment epithelium detachment (PED) in eyes with age-related macular degeneration. METHODS: Hundred and fifty-three patients (161 eyes) with subfoveal occult CNV due to age-related macular degeneration, were divided into two groups. The first group (70 patients, 75 eyes) included eyes with occult CNV associated with serous PED of at least 1 disc diameter in size and the second (83 patients, 86 eyes) eyes with late leakage of undetermined source. All the patients were treated with PDT. The follow-up time ranged from 12 to 48 months. RESULTS: At the last examination, in the first group, the visual acuity (VA) improved or remained stable in 17 (22.7%) and decreased in 58 (77.3%). In the second group, the VA improved or remained stable in 37 (43%) and decreased in 49 (57%). The difference in the change (decrease) in the VA between the two groups was statistically very significant (p = 0.0075). Retinal pigment epithelium tear occurred in 15 eyes (20%) of the first group. CONCLUSION: Our study showed that the visual prognosis of eyes treated with PDT due to subfoveal occult CNV associated with serous PED is not favorable. We believe that the distinction between the two forms of occult CNV is essential, as they carry a different prognosis.