Universität zu Köln

van Dijk, Elon H. C., Fauser, Sascha, Breukink, Myrte B., Blanco-Garavito, Rocio, Groenewoud, Joannes M. M., Keunen, Jan E. E., Peters, Petrus J. H., Dijkman, Greet, Souied, Eric H., MacLaren, Robert E., Querques, Giuseppe ORCID: 0000-0002-3292-9581, Downes, Susan M., Hoyng, Carel B. and Boon, Camiel J. F. (2018). Half-Dose Photodynamic Therapy versus High-Density Subthreshold Micropulse Laser Treatment in Patients with Chronic Central Serous Chorioretinopathy The PLACE Trial. Ophthalmology, 125 (10). S. 1547 - 1556. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1549-4713

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Abstract

Purpose: To compare the anatomic and functional efficacy and safety of half-dose photodynamic therapy (PDT) versus high-density subthreshold micropulse laser (HSML) treatment in patients with chronic central serous chorioretinopathy (cCSC). Design: Open-label, multicenter, randomized controlled clinical trial. Participants: Patients with cCSC whose disease had to be confirmed by both clinical characteristics and findings on multimodal imaging. Methods: Eligible patients were randomized in a 1:1 allocation ratio. Treatment was evaluated during a follow-up visit, and the same treatment was repeated in patients who still demonstrated subretinal fluid (SRF). Main Outcome Measures: The primary end point was the complete disappearance of SRF at the first evaluation visit at 6 to 8 weeks after treatment. As a secondary outcome measure, we assessed this anatomic result at the final evaluation visit at 7 to 8 months after treatment. Other secondary outcomes covered functional improvement and included change in best-corrected visual acuity (BCVA; measured in Early Treatment Diabetic Retinopathy Study [ETDRS] letters), retinal sensitivity (measured using microperimetry), and vision-related quality of life using a validated questionnaire. Results: Between November 2013 and September 2016, 179 patients were included: 89 patients were assigned randomly to half-dose PDT, and 90 were assigned randomly to HSML treatment. At their first evaluation visit, SRF had resolved in 51.2% and 13.8% of patients, respectively (P < 0.001). At their final evaluation visit, a significantly higher percentage of PDT-treated patients demonstrated no SRF (67.2% vs. 28.8%; P < 0.001). Moreover, at the first evaluation visit, the PDT-treated patients showed a significantly higher increase in BCVA (+4.60 +/- 6.62 ETDRS letters vs. +1.39 +/- 8.99 ETDRS letters; P = 0.011), and a significantly higher increase in retinal sensitivity on microperimetry (+2.01 +/- 3.04 dB vs. +0.92 +/- 3.65 dB; P = 0.046); however, the improvement in vision-related quality of life was similar (score of +2.87 +/- 8.35 vs. +2.56 +/- 7.36, respectively; P = 0.800). Conclusions: Half-dose PDT is superior to HSML for treating cCSC, leading to a significantly higher proportion of patients with complete resolution of SRF and functional improvement. (C) 2018 by the American Academy of Ophthalmology.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code van Dijk, Elon H. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fauser, Sascha UNSPECIFIED UNSPECIFIED UNSPECIFIED Breukink, Myrte B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Blanco-Garavito, Rocio UNSPECIFIED UNSPECIFIED UNSPECIFIED Groenewoud, Joannes M. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Keunen, Jan E. E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Peters, Petrus J. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dijkman, Greet UNSPECIFIED UNSPECIFIED UNSPECIFIED Souied, Eric H. UNSPECIFIED UNSPECIFIED UNSPECIFIED MacLaren, Robert E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Querques, Giuseppe UNSPECIFIED orcid.org/0000-0002-3292-9581 UNSPECIFIED Downes, Susan M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoyng, Carel B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boon, Camiel J. F. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-171802
DOI:	10.1016/j.ophtha.2018.04.021
Journal or Publication Title:	Ophthalmology
Volume:	125
Number:	10
Page Range:	S. 1547 - 1556
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1549-4713
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MACULAR DEGENERATION; CHOROIDAL NEOVASCULARIZATION; FOLLOW-UP; 577 NM; VERTEPORFIN; FLUENCE Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17180