July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Changes on multimodal imaging after treatment with photodynamic therapy or high-density subthreshold micropulse laser in chronic central serous chorioretinopathy
Author Affiliations & Notes
  • Thomas Jurian van Rijssen
    Leiden University Medical Center, Leiden, Netherlands
  • Leo C Hahn
    Leiden University Medical Center, Leiden, Netherlands
  • Elon Van Dijk
    Leiden University Medical Center, Leiden, Netherlands
  • Paula Scholz
    Ophthalmology, University Hospital of Cologne, Cologne, Germany
  • Myrte Breukink
    Ophthalmology, Radboud University Medical Center, Netherlands
  • Eric H Souied
    Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, France
  • Robert E MacLaren
    John Radcliffe Hospital, West Wing, Oxford, United Kingdom
  • Giuseppe Querques
    IRCCS Ospedale San Raffaele, Vita-Salute University, Italy
    Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, France
  • Sascha Fauser
    F. Hoffmann-La Roche, Basel, Switzerland
    Ophthalmology, University Hospital of Cologne, Cologne, Germany
  • Susan M. Downes
    John Radcliffe Hospital, West Wing, Oxford, United Kingdom
  • Carel C B Hoyng
    Ophthalmology, Radboud University Medical Center, Netherlands
  • Camiel Boon
    Leiden University Medical Center, Leiden, Netherlands
    Amsterdam UMC, University of Amsterdam, Netherlands
  • Footnotes
    Commercial Relationships   Thomas van Rijssen, None; Leo Hahn, None; Elon Van Dijk, None; Paula Scholz, None; Myrte Breukink, None; Eric Souied, None; Robert MacLaren, None; Giuseppe Querques, None; Sascha Fauser, None; Susan Downes, None; Carel Hoyng, None; Camiel Boon, None
  • Footnotes
    Support  Supported by Stichting Macula Fonds; Retina Nederland Onderzoek Fonds; Stichting Blinden-Penning; Algemene Nederlandse Vereniging ter Voorkoming van Blindheid; Landelijke Stichting voor Blinden en Slechtzienden, which contributed through UitZicht (Delft, the Netherlands); Rotterdamse Stichting Blindenbelangen (Rotterdam, the Netherlands); Stichting Leids Oogheelkundig Ondersteuningsfonds (Leiden, the Netherlands); Haagse Stichting Blindenhulp (The Hague, the Netherlands); Stichting Ooglijders (Rotterdam, the Netherlands); and the Oxford NIHR Biomedical Research Center (Oxford, United Kingdom); the Gisela Thier Fellowship of Leiden University, Leiden, the Netherlands (C.J.F.B.); and the Netherlands Organisation for Scientific Research (VENI grant to C.J.F.B.). These funding organizations provided unrestricted grants and had no role in the design or conduct of this research. This investigator-initiated study received funding from Novartis Pharma B.V. (Arnhem, the Netherlands) solely for the purchase of verteporfin (Visudyne) to enable photodynamic therapy treatment at the Oxford site, because photodynamic therapy currently is not reimbursed routinely by the United Kingdom National Health Service for treating central serous chorioretinopathy. Novartis Pharma B.V. had no role in funding, designing, conducting, or evaluating the study, nor in the writing of this manuscript
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1155. doi:https://doi.org/
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      Thomas Jurian van Rijssen, Leo C Hahn, Elon Van Dijk, Paula Scholz, Myrte Breukink, Eric H Souied, Robert E MacLaren, Giuseppe Querques, Sascha Fauser, Susan M. Downes, Carel C B Hoyng, Camiel Boon; Changes on multimodal imaging after treatment with photodynamic therapy or high-density subthreshold micropulse laser in chronic central serous chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1155. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare the effect of half-dose photodynamic therapy (PDT) and high-density subthreshold micropulse laser (HSML) on the size of hyperfluorescent abnormalities on indocyanine green angiography (ICGA) and retinal pigment epithelial detachments (PED) in chronic central serous chorioretinopathy (cCSC).

Methods : Recruited cCSC patients were randomized to HSML or PDT treatment. The change of hyperfluorescent areas on ICGA and change in PED height at baseline compared to the first and final evaluation visit were obtained.

Results : A total of 154 patients could be included (74 patients received half-dose PDT and 80 patients received HSML treatment). Treatment with PDT resulted in a significantly higher reduction in the total size of the hyperfluorescent area as compared to HSML, both at first evaluation visit (median: -0.5 mm2, interquartile range (IQR): -2.4 to -0.05 mm2 in the PDT group vs median: 0.0 mm2, IQR: -0.3 to +0.2 mm2 in the HSML group, p<0.001) and final evaluation visit (median: -0.2 mm2, IQR: -0.7 to -0.1 mm2 in the PDT group vs median: -0.04 mm2, IQR: -0.3 to +0.4 mm2 in the HSML group, p=0.030). There was a significantly higher decrease in PED height in the PDT group, both at first evaluation visit (median: -7.0 μm, IQR: -20.2 to -1.0 μm in the PDT group vs median: -1.5 μm, IQR: -8.0 to +1.0 μm in the HSML group, p=0.009) and at final evaluation visit (median: -12.0 μm, IQR: -26.0 to -4.0 μm in the PDT group vs median: -7.0 μm, IQR: -16.5 to 0.0 μm in the HSML group, p=0.020).

Conclusions : Treatment with half-dose PDT leads to a significant decrease in the area of hyperfluorescence on ICGA and PED height, while HSML does not affect these parameters. These effects on choroidal hyperfluorescence and PED on multimodal imaging appear to reflect the difference in treatment efficacy in favor of half-dose PDT that was found in the PLACE trial.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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