TRANSIENT PARADOXICAL WORSENING OF VISION DUE TO GRAVITATIONAL SHIFT OF SUBRETINAL FLUID AFTER PHOTODYNAMIC THERAPY FOR CENTRAL SEROUS CHORIORETINOPATHY.

Purpose: To report an atypical treatment-related complication from photodynamic therapy in central serous chorioretinopathy patient and explain its mechanism.

Methods: History, physical examination, and imaging data were retrospectively reviewed and obtained from the electronic medical records of the patient.

Results: A central serous chorioretinopathy patient with several focal leakage spots near the superotemporal arcade was treated with half-fluence verteporfin photodynamic therapy. The patient complained of worse vision after the treatment. Examination showed relocation of subretinal fluid from the superior macula to the central and submacular area, explained by a gravitational shift of subretinal fluid and the predisposing factor of a previously weakened junction between the retinal pigment epithelium and neurosensory retina. Without further treatment, the fluid reabsorbed, and the patient's vision returned to normal.

Conclusion: This is the first report to describe this transient atypical adverse visual outcome early after photodynamic therapy in a central serous chorioretinopathy patient, caused by a gravitational shift of viscous subretinal fluid.