The authors evaluated the proportion of choroidal neovascularization (CNV) detected by spectral-domain optical coherence tomography angiography (OCTA) in eyes with chronic central serous chorioretinopathy (CSC) (more than 3 months) with previous treatment via half-dose photodynamic therapy (PDT). All patients were followed up with at least twelve months. Macular angiograms were obtained using spectral-domain OCT (SD-OCT, RTVue XR; Optovue). CNV was defined as flow in the outer retinal slab between the outer plexiform layer and Bruch’s membrane. Clinical characteristics were compared between CNV and non-CNV groups. Seventy eyes of 61 patients (51 male and 10 female) were included. The average age was 46.2 years old. The average duration of symptom was 32.9 months. All patients were treated with half-dose PDT initially. Eleven eyes (15.7%) received more than one session of PDT. CNV was diagnosed in 32 of 70 eyes (45.7%) based on OCTA. Only 6 of the 32 eyes (18.8%) needed intravitreal anti- vascular endothelial growth factor (VEGF) therapy for the exudative activity of CNV. Older age (p = 0.059), larger PDT spot size (p = 0.024), and thinner subfoveal choroidal thickness (p = 0.008) were noted in CNV group. The authors conclude that OCTA reveals high rates of CNV associated with chronic CSC after PDT. Patients in the CNV group had older age, larger PDT spot size, and thinner subfoveal choroidal thickness. OCTA may be considered as a first step in identifying CNV in chronic CSC following PDT.

Given the rising prevalence of patients with diabetes and increasing treatment burden for patients with vision-threatening diabetic macular edema (DME), we aimed to explore the efficacy of modified early intensive and treat-and-extend regimen of anti-vascular endothelial growth factor (VEGF) therapy under the Taiwan National Insurance Bureau reimbursement policy. We obtained data on 69 eyes treated with initial 4-monthly intravitreal injections of aflibercept or ranibizumab, plus individualized treat-and-extend regimen. At 12 months, the mean (SD) change in LogMAR best corrected visual acuity from baseline was − 0.28 (0.31) in all eyes, while that in the aflibercept and ranibizumab groups were − 0.30 (0.34) and − 0.25 (0.28), respectively. Central retinal thickness decreased by 137.2 (122.4) in all eyes, 138.1 (134.2) in the aflibercept group, and 136.2 (110.9) in the ranibizumab group. Additionally, the aflibercept group had a lower mean number of injections than the ranibizumab group (8.5 vs. 8.7). The last extended dosing interval of > 12 weeks was 31.0% and 16.7% of the eyes in the aflibercept and ranibizumab groups, respectively. The modified anti-VEGF regimens effectively managed DME in terms of functional and anatomical outcomes, and efficiently reduced the healthcare burden by reducing the number of injections and extending treatment intervals within 12 months.