Journal
AMERICAN JOURNAL OF OPHTHALMOLOGY
Volume 216, Issue -, Pages 80-89Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ajo.2020.04.007
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Funding
- STICHTINGMACULAFONDS
- RETINA Nederland Onderzoek Fonds
- Stichting Blinden-Penning
- Algemene Nederlandse Vereniging ter Voorkoming van Blindheid
- Landelijke Stichting voor Blinden en Slechtzienden through UitZicht (Delft, the Netherlands)
- Rotterdamse Stichting Blindenbelangen (Rotterdam, the Netherlands)
- Stichting LeidsOogheelkundigOndersteuningsfonds (Leiden, the Netherlands)
- Haagse Stichting Blindenhulp (TheHague, theNetherlands)
- Stichting Ooglijders (Rotterdam, the Netherlands)
- OxfordNIHR Biomedical Research Centre (Oxford, United Kingdom)
- Gisela Thier Fellowship of Leiden University, Leiden, the Netherlands
- Netherlands Organization for Scientific Research (VENI)
- Novartis Pharma B.V. (Arnhem, the Netherlands)
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PURPOSE: To assess whether chronic central serous chorioretinopathy (cCSC) patients without a complete resolution of subretinal fluid (SRF) after either half-dose photodynamic therapy (PDT) or high-density subthreshold micropulse laser (HSML) treatment may benefit from crossover treatment. DESIGN: Multicenter prospective interventional case series. METHODS: cCSC patients with persistent SRF at the final visit of the PLACE trial were included. Patients received crossover treatment with either half-dose PDT or HSML. RESULTS: Thirty-two patients received PDT and 10 patients received HSML. At the first evaluation visit (6-8 weeks after treatment), 81% of patients in the PDT group had complete resolution of SRF, while none of the HSML-treated patients had complete resolution of SRF. At final visit (1 year after baseline), 78% (P = .030) and 67% (P = .109) of the patients, respectively, had a complete resolution of SRF. The mean retinal sensitivity in the PDT group increased from 21.7 dB (standard error [SE]: 0.9) to 23.4 dB (SE: 0.8) at evaluation visit 1 (P = .003), to 24.7dB (SE: 0.8) at final visit (P < .001), while there were no significant changes in the HSML group (23.7 dB [SE: 1.6] at baseline, 23.8 dB [SE: 1.4] at evaluation 1, and 23.3 dB [SE: 1.4] at final visit). The mean visual acuity and mean visual quality-of-life questionnaire score did not change significantly in both groups. CONCLUSIONS: Crossover to half-dose PDT after previous unsuccessful HSML treatment for cCSC may lead to improved anatomic and functional endpoints, while crossover to HSML after half-dose PDT does not seem to significantly affect these endpoints. (C) 2020 The Authors. Published by Elsevier Inc.
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