In this preliminary study, the exposition of irregular working hours as a risk factor for chronic ICSC was identified, which had not been previously reported. If further studies confirm these findings, then employment with regular working hours could be recommended for chronic ICSC patients.

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Purpose In chronic idiopathic central serous chorioretinopathy (ICSC), recent studies indicate that photodynamic therapy (PDT) could be effective in subretinal fluid resorption with reduced dose of verteporfin (3mg/m2) and reduced fluence PDT. However safety and cost issues remain to be addressed. This prospective randomized controlled study has been designed to evaluate the efficacy of a further reduced dose of verteporfin for PDT in chronic ICSC. Methods Patients with chronic ICSC greater than 3 months of documented duration were included. Visual acuity had to be <20/40. The patients were randomly assigned to 2 treatment groups. They received either 3 mg/m2 or 1,5 mg/m2 verteporfin and reduced fluence PDT. All patients had visual acuity, ocular coherent tomography (OCT), fluorescein and indocyanine green (ICG) angiography on inclusion, follow up was based on ETDRS and OCT at 6 weeks, 3 and 6 months. Results Ten patients were included, randomized to each treatment group. Mean duration of symptoms prior to PDT was 6 months. After 6 month follow‐up, no significant difference between the 2 groups was observed: the reduction of mean foveal thickness was equivalent in both groups. In all treated eyes, visual acuity remained stable or improved. OCT showed a reduction in serous detachment in 2 eyes of 10 eyes, complete resolution was demonstrated in 8 of 10 eyes. None of the eyes required more than 1 treatment for recurrent serous detachment. Conclusion Our preliminary data suggest that PDT leads to resolution of serous detachments and visual improvement in patients with chronic ICSC even with a low dose of verteporfin. This will reduce the cost of PDT for each patient. Long term follow‐up should enable to address safety issues.

Purpose Chronic central serous chorioretinopathy (CSCR) is a multifactorial disease. The present study was designed to evaluate the prevalence of circadian disturbance and corticosteroid treatment in patients treated with chronic CSCR. Methods Patients presenting with chronic CSCR between 01/01/2009 and 30/11/2011 were prospectively enrolled. A history of corticosteroid treatment, sleep disturbances and irregular working hours was noted. Two questionnaires (PSQI and Epworth) regarding sleeping distrurbancies were applied. After a follow up of 3 months, the patients with persisting fluid and visual acuity below 20/40 were treated with photodynamic therapy (PDT). Results During the period of inclusion, among 26 included patients, 19 were treated with PDT (73%). A history of corticosteroid tretment was found in 12 patients (19%), 4 currently used psychopharmacologic drugs (15%) and 8 had irregular working hours (30%). The analysis of the Epworth questionnaire enabled to record moderate sleeping disturbances in 11 patients (42%), none of the patients were classified as having severe sleeping disturbances. Conclusion It is likely that general factors such as the existence of a corticosteroid treatment or a disruption of the circadian cycle are involved in the occurrence of patients with CSCR.