Persistent visual field deficit after half-fluence photodynamic therapy for chronic central serous chorioretinopathy.

Purpose: To report a rare case of a persistent paracentral scotoma after half-fluence photodynamic therapy for chronic central serous chorioretinopathy.

Methods: A 65-year-old man with a history of chronic central serous chorioretinopathy presented with a temporal paracentral visual distortion one week after undergoing repeat off-label treatment with half-fluence verteporfin photodynamic therapy for recurrent intraretinal fluid exudation in the right eye. Fundus photography, fundus autofluorescence, optical coherence tomography, fluorescein angiography, indocyanine green angiography, and automatic visual field testing were obtained.

Results: Humphrey visual field 10-2 demonstrated a focal temporal paracentral area of reduced sensitivity, which remained persistent on repeat testing up to 9 months. OCT macula and fluorescein angiography demonstrated subtle corresponding changes in the nasal macula, while indocyanine green angiography demonstrated no visible alteration in choroidal perfusion.

Conclusion: Symptomatic scotoma in the location of laser treatment may be a rare complication of verteporfin photodynamic therapy even at reduced fluence, in the setting of repeat treatment in the same location, and may be identified and monitored with automated 10-2 visual field testing.