Thomas J van Rijssen1, Elon H C van Dijk1, Paula Scholz2, Myrte B Breukink3, Greet Dijkman1, Petrus J H Peters4, Roula Tsonaka5, Robert E MacLaren6, Susan M Downes6, Sascha Fauser7, Camiel J F Boon8, Carel B Hoyng3. 1. Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands. 2. Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany. 3. Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands. 4. Department of Ophthalmology, Bergman Clinics B.V., Velp, The Netherlands. 5. Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands. 6. Oxford Eye Hospital, John Radcliffe Hospital, West Wing, Oxford, United Kingdom. 7. Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany; F. Hoffmann-La Roche, Basel, Switzerland. 8. Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands; Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: c.j.f.boon@lumc.nl.
Abstract
PURPOSE: To assess whether chronic central serous chorioretinopathy (cCSC) patients without a complete resolution of subretinal fluid (SRF) after either half-dosephotodynamic therapy (PDT) or high-density subthreshold micropulse laser (HSML) treatment may benefit from crossover treatment. DESIGN: Multicenter prospective interventional case series. METHODS:cCSC patients with persistent SRF at the final visit of the PLACE trial were included. Patients received crossover treatment with either half-dose PDT or HSML. RESULTS: Thirty-two patients received PDT and 10 patients received HSML. At the first evaluation visit (6-8 weeks after treatment), 81% of patients in the PDT group had complete resolution of SRF, while none of the HSML-treated patients had complete resolution of SRF. At final visit (1 year after baseline), 78% (P = .030) and 67% (P = .109) of the patients, respectively, had a complete resolution of SRF. The mean retinal sensitivity in the PDT group increased from 21.7 dB (standard error [SE]: 0.9) to 23.4 dB (SE: 0.8) at evaluation visit 1 (P = .003), to 24.7dB (SE: 0.8) at final visit (P < .001), while there were no significant changes in the HSML group (23.7 dB [SE: 1.6] at baseline, 23.8 dB [SE: 1.4] at evaluation 1, and 23.3 dB [SE: 1.4] at final visit). The mean visual acuity and mean visual quality-of-life questionnaire score did not change significantly in both groups. CONCLUSIONS: Crossover to half-dose PDT after previous unsuccessful HSML treatment for cCSC may lead to improved anatomic and functional endpoints, while crossover to HSML after half-dose PDT does not seem to significantly affect these endpoints.
RCT Entities:
PURPOSE: To assess whether chronic central serous chorioretinopathy (cCSC) patients without a complete resolution of subretinal fluid (SRF) after either half-dose photodynamic therapy (PDT) or high-density subthreshold micropulse laser (HSML) treatment may benefit from crossover treatment. DESIGN: Multicenter prospective interventional case series. METHODS: cCSC patients with persistent SRF at the final visit of the PLACE trial were included. Patients received crossover treatment with either half-dose PDT or HSML. RESULTS: Thirty-two patients received PDT and 10 patients received HSML. At the first evaluation visit (6-8 weeks after treatment), 81% of patients in the PDT group had complete resolution of SRF, while none of the HSML-treated patients had complete resolution of SRF. At final visit (1 year after baseline), 78% (P = .030) and 67% (P = .109) of the patients, respectively, had a complete resolution of SRF. The mean retinal sensitivity in the PDT group increased from 21.7 dB (standard error [SE]: 0.9) to 23.4 dB (SE: 0.8) at evaluation visit 1 (P = .003), to 24.7dB (SE: 0.8) at final visit (P < .001), while there were no significant changes in the HSML group (23.7 dB [SE: 1.6] at baseline, 23.8 dB [SE: 1.4] at evaluation 1, and 23.3 dB [SE: 1.4] at final visit). The mean visual acuity and mean visual quality-of-life questionnaire score did not change significantly in both groups. CONCLUSIONS: Crossover to half-dose PDT after previous unsuccessful HSML treatment for cCSC may lead to improved anatomic and functional endpoints, while crossover to HSML after half-dose PDT does not seem to significantly affect these endpoints.
Authors: Helena M A Feenstra; Elon H C van Dijk; Thomas J van Rijssen; Roula Tsonaka; Roselie M H Diederen; Carel B Hoyng; Reinier O Schlingemann; Camiel J F Boon Journal: Graefes Arch Clin Exp Ophthalmol Date: 2022-10-07 Impact factor: 3.535
Authors: Thomas J van Rijssen; Elon H C van Dijk; Paula Scholz; Myrte B Breukink; Greet Dijkman; Petrus J H Peters; Roula Tsonaka; Jan E E Keunen; Robert E MacLaren; Carel B Hoyng; Susan M Downes; Sascha Fauser; Camiel J F Boon Journal: Acta Ophthalmol Date: 2021-02-10 Impact factor: 3.761