RESPONSE OF CHOROIDAL ABNORMALITIES TO PHOTODYNAMIC THERAPY VERSUS MICROPULSE LASER IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY: Place Trial Report No. 4.

Abstract

PURPOSE:

To compare the effects of half-dose photodynamic therapy (PDT) and high-density subthreshold micropulse laser on choroidal dysfunction evaluated by degree and extent of hyperfluorescence on indocyanine green angiography (ICGA) in chronic central serous chorioretinopathy.

METHODS:

Data from the multicenter, randomized, controlled PLACE trial were used in this study. Hyperfluorescent and hypofluorescent areas on ICGA, their association with subretinal fluid and visual function were assessed.

RESULTS:

In total, 146 patients were included (72 in the PDT and 74 in the high-density subthreshold micropulse laser treatment arm). A significantly greater decrease in the size of hyperfluorescent areas on ICGA at first visit after treatment was seen after PDT compared with high-density subthreshold micropulse laser (mean, -1.41 ± 2.40 mm2 vs. -0.04 ± 0.73 mm2, respectively; P < 0.001). A reduction in the degree of hyperfluorescence on ICGA decreased the odds of having persistent subretinal fluid on optical coherence tomography at first visit after treatment (B = 0.295; P = 0.019). There were no significant differences in best-corrected visual acuity and retinal sensitivity between the subgroup with novel hypofluorescence (n = 20, 28%) on ICGA at first visit post PDT, compared with the subgroup without novel hypofluorescence on ICGA after PDT.

CONCLUSION:

Choroidal abnormalities in chronic central serous chorioretinopathy can be effectively treated by ICGA-guided half-dose PDT but not with high-density subthreshold micropulse laser application.

• Authors: Thomas J van Rijssen, Leo C Hahn, Elon H C van Dijk, Roula Tsonaka, Paula Scholz, Myrte B Breukink, Rocio Blanco-Garavito, Eric H Souied, Jan E E Keunen, Robert E MacLaren, Giuseppe Querques, Sascha Fauser, Susan M Downes, Carel B Hoyng, Camiel J F Boon
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 41 Issue 10 Pg. 2122-2131 (Oct 01 2021) ISSN: 1539-2864 [Electronic] United States
• PMID: 34543244 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Coloring Agents
• Photosensitizing Agents
• Verteporfin
• Indocyanine Green

Topics

• Adult
• Central Serous Chorioretinopathy (drug therapy, physiopathology, surgery, therapy)
• Choroid (diagnostic imaging, physiopathology)
• Chronic Disease
• Coloring Agents (administration & dosage)
• Female
• Fluorescein Angiography
• Humans
• Indocyanine Green (administration & dosage)
• Laser Therapy
• Male
• Middle Aged
• Photochemotherapy
• Photosensitizing Agents (therapeutic use)
• Prospective Studies
• Retina (physiopathology)
• Subretinal Fluid
• Tomography, Optical Coherence
• Verteporfin (therapeutic use)
• Visual Acuity (physiology)