Waking up to find the world around you blurred and unrecognizable can be a distressing experience, one that individuals with Central Serous Chorioretinopathy (CSCR) know all too well. This eye condition sneaks up like a shadow, obscuring the clarity of vision and impacting lives during peak productive years. With fluid building up beneath the retina, the quest for clear sight becomes a daily challenge. Traditional treatments have yielded mixed results, leaving many in search of a beacon of hope. This journey into the unknown serves as the backdrop for a study exploring a well known, but sometimes forgotten or avoided due to high cost , treatment path, potentially illuminating a brighter future for those veiled in the uncertainty of CSCR.

Central Serous Chorioretinopathy (CSCR) remains a challenging condition, often presenting with subretinal fluid (SRF) accumulation that can significantly affect visual acuity. Traditionally, treatments such as subthreshold micropulse laser (SML) have been employed, albeit with varying success rates. A recent study led by Professor Andrzej Grzybowski from the University of Warmia and Mazury and Dr. Maciej Gawęcki from Pomeranian Hospitals in Wejherowo, with contributions from Dr. Krzysztof Kiciński also from Pomeranian Hospitals in Wejherowo, published in the Advances in Ophthalmology Practice and Research, sheds light on approach to managing chronic CSCR cases unresponsive to SML treatments. Their research pivots on the efficacy and durability of Photodynamic Therapy (PDT) in such scenarios.

The study meticulously tracked the journey of several patients who found no relief from SRF after undergoing rounds of SML treatment. These participants, mostly male and in the prime of their lives, had been enduring symptoms for a significant period. The methodical approach adopted by the researchers allowed for a comprehensive evaluation of PDT’s effectiveness over time. Remarkably, the majority of the treated eyes showed complete absorption of SRF shortly after treatment, with a substantial portion maintaining this success longer-term. This progression was marked by notable improvements in both the clarity of vision and the physical measurements of the eye’s anatomy.

Professor Grzybowski, offering insights from the study, emphasized, “The majority of eyes saw a significant improvement shortly after treatment, which was largely maintained in the long term. As a result, visual clarity was notably enhanced for many participants.” Despite the overall success, it’s essential to note that not all patients responded to PDT, with the study pinpointing age as a potential factor affecting treatment efficacy. Dr. Gawęcki pointed out, “A notable age difference was observed between those who responded to the treatment and those who did not.”

Reflecting on the broader implications of their work, Professor Grzybowski added, “PDT offers a new hope for those who have not seen improvement with SML. Even in longstanding cases with significant changes in the eye’s structure, we’ve seen improvements.” This perspective provides encouragement for patients with chronic CSCR, suggesting that PDT could be a promising alternative even when other treatments have failed or should be more often considered a first line therapy.

The methodology of the study was crafted to ensure clarity and accessibility for a broad audience. By carefully selecting participants who had not seen improvements with SML and meticulously tracking their progress through non-invasive imaging techniques, the study provides a robust framework for evaluating PDT’s efficacy. This approach emphasizes the real-world applications and benefits of the treatment, making the findings relevant and understandable to patients and practitioners alike. In summary, the transition to PDT in cases where SML falls short presents a new beacon of hope for individuals grappling with chronic CSCR. The research spearheaded by Professor Grzybowski, Dr. Gawęcki and Dr. Kiciński not only enhances our comprehension of effective CSCR management strategies but also champions the need for personalized treatment plans.


Dr. Maciej Gawęcki, Dr. Krzysztof Kiciński from Pomeranian Hospitals in Wejherowo, and Professor Andrzej Grzybowski from the University of Warmia and Mazury. “Crossover to PDT after the unsuccessful micropulse laser treatment of central serous chorioretinopathy.” Advances in Ophthalmology Practice and Research, 2024.

DOI: https://doi.org/10.1016/j.aopr.2024.01.004.


Prof. Andrzej Grzybowski biosketch

Andrzej Grzybowski, M.D., Ph.D., MBA, MAE, EVERf is a Professor of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; Head of Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland.

He is active in international scientific societies including Euretina (Co-opted Board member 2016-2018), President of European Vision & Eye Research Association (EVER), ESCRS (curator of ESCRS Archive), and ISRS (member of the ISRS International Council), International Intraocular Implant Club and Cogan Society. He became a lifelong member (chair LIV) of the European Academy of Ophthalmology (https://eao-academy.eu) and its Treasurer, and a member of the Academia Europea (www.ae-info.org).

As the only Polish ophthalmologist he was included in the TOP 2% ranking of world-best scientists prepared by Stanford University for 2019 and 2020. Expertscape worldwide ranking: No 1 in cataract field and No 1 in cataract extraction field; No 3 in endophthalmitis field. In 2021, he received ISRS (International Society for Refractive Surgery) Founders’ Award and published a book Artificial Intelligence in Ophthalmology (Springer). In 2022 he was awarded OFFICERS’ CROSS OF THE ORDER OF POLONIA RESTITUTA for outstanding achievements in research and teaching, and support for international scientific cooperation by the President of Poland; listed on the “The Power List” by The Ophthalmologist magazine, a ranking of the Top 100 most influential people in the world of ophthalmology (https://theophthalmologist.com/power-list/2022), awarded by Marshal of Warmia and Mazury Region “The best of the best” recognition for scientific achievements, and by the Award by Rector of Warmia and Mazury University for the best publications in 2021.

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