Spectral domain optical coherence tomography and angiographic findings in multifocal posterior pigment epitheliopathy treated with low-fluence photodynamic therapy

Purpose The aim was to evaluate spectral domain optical coherence tomographic (SD-OCT), fluorescein angiography (FA) and indocyanine green angiography (ICGA) findings in multifocal posterior pigment epitheliopathy (MPPE) treated with low-fluence photodynamic therapy. Methods A 54-year-old Japanese man with serous retinal detachment (SRD) and pigment epithelial detachment (PED) due to multifocal posterior pigment epitheliopathy in the right eye was managed with ICGA-guided low-fluence photodynamic therapy. Outcome measures included visual acuity, SD-OCT appearance and FA and ICGA findings. Results The patient received low-fluence photodynamic therapy within two weeks after the onset of symptoms. After treatment, serous retinal detachment and PED resolved in two weeks. Visual acuity returned to 1.0, the external limiting membrane and the photoreceptor inner and outer segment junction integrity were restored and the subfoveal choroidal thickness was greatly reduced. There has been no recurrence in six months. FA demonstrated stoppage of leakage and ICGA showed a marked decrease of choroidal venous dilation and vascular hyperpermeability. Conclusion To our knowledge, this is the first report to examine photoreceptor integrity, foveal choroidal thickness and choroidal circulation in a case of MPPE treated with low-fluence photodynamic therapy. Early application of the photodynamic therapy led to restoration of photoreceptor integrity with improvement of choroidal thickness and circulation.