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