June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Long-term follow-up of chronic central serous chorioretinopathy patients after primary treatment of oral eplerenone or half-dose photodynamic therapy and crossover treatment: SPECTRA trial report No. 3
Author Affiliations & Notes
  • Helena Feenstra
    Ophthalmology, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
  • Thomas Jurian van Rijssen
    Ophthalmology, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
  • Roselie Diederen
    Amsterdam UMC Locatie AMC, Amsterdam, North Holland, Netherlands
  • Carel Hoyng
    Radboudumc, Nijmegen, Gelderland, Netherlands
  • Reinier Schlingemann
    Amsterdam UMC Locatie AMC, Amsterdam, North Holland, Netherlands
  • Elon van Dijk
    Ophthalmology, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
  • Camiel J F Boon
    Ophthalmology, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
  • Footnotes
    Commercial Relationships   Helena Feenstra, None; Thomas van Rijssen, None; Roselie Diederen, None; Carel Hoyng, None; Reinier Schlingemann, None; Elon van Dijk, None; Camiel Boon, None
  • Footnotes
    Support  UitZicht, Rotterdamse Stichting Blindenbelangen, Stichting Leids Oogheelkundig Ondersteuningsfonds, Haagse Stichting Blindenhulp, Stichting Ooglijders, Gisela Thier Fellowship of Leiden University, and the Netherlands Organization for Scientific Research.
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2170. doi:
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      Helena Feenstra, Thomas Jurian van Rijssen, Roselie Diederen, Carel Hoyng, Reinier Schlingemann, Elon van Dijk, Camiel J F Boon; Long-term follow-up of chronic central serous chorioretinopathy patients after primary treatment of oral eplerenone or half-dose photodynamic therapy and crossover treatment: SPECTRA trial report No. 3. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2170.

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

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Abstract

Purpose : We performed an open-label, multicenter, randomized controlled trial to compare the anatomic and functional efficacy and safety of primary treatment with either half-dose photodynamic therapy (PDT) or oral eplerenone treatment, with or without crossover treatment in patients with chronic central serous chorioretinopathy (cCSC).

Methods : After the baseline visit of the SPECTRA trial, eligible patients were randomized in a 1:1 allocation ratio. Treatments involved indocyanine green angiography (ICGA)-guided half-dose PDT versus oral eplerenone for 12 weeks. Crossover treatment was performed in patients with persistent subretinal fluid (SRF) on optical coherence tomography (OCT) scanning at the first follow-up visit. The 2 crossover groups included 38/46 patients (82.6%) of the patients who received primary oral eplerenone, and 11/50 patients (22.0%) of the patients who received primary half-dose PDT. The presence of SRF on OCT, best-corrected visual acuity (BCVA), and both retinal and foveal sensitivity on microperimetry were evaluated during a final follow-up visit at 12 months after baseline.

Results : Out of the 96 patients who were evaluated at first follow-up visit, 49 patients had persistent SRF on OCT (38 in the eplerenone group and 11 in the half-dose PDT group). Out of 90 the patients who had a final follow-up visit, 38/39 (97.4%) in the group with primary resolution after half-dose PDT, 7/7 (100%) in the group with primary resolution after eplerenone, 30/35 (85.7%) in the group who received crossover from eplerenone to half-dose PDT, and 5/9 (55.5%) in the group who received crossover from half-dose PDT to eplerenone group, had a complete resolution of SRF on OCT. There were no differences in BCVA and retinal or foveal sensitivity between the groups at final visit.

Conclusions : Half-dose PDT is the treatment of choice for achieving complete resolution of SRF in cCSC, even after previous eplerenone treatment. Twelve months after baseline visit, most patients treated with half-dose PDT (either primary or crossover treatment) still had a complete resolution of SRF. Crossover after half-dose PDT to eplerenone is less likely to result in complete SRF resolution at long-term follow-up.

This is a 2021 ARVO Annual Meeting abstract.

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