Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany.
Acta Ophthalmol. 2021 Nov;99(7):805-811. doi: 10.1111/aos.14775. Epub 2021 Feb 10.
To describe the treatment outcomes and recurrence risk of chronic central serous chorioretinopathy (cCSC) in patients who had complete resolution of subretinal fluid (SRF) after either primary half-dose photodynamic therapy (PDT) or high-density subthreshold micropulse laser (HSML) in the PLACE trial.
This multicentre prospective follow-up study evaluated cCSC patients at 1 year after completion of the PLACE trial. Outcomes included: complete resolution of SRF on OCT, best-corrected visual acuity (BCVA) in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters, retinal sensitivity on microperimetry and a visual function questionnaire (NEI-VFQ25).
Twenty-nine out of 37 patients who received half-dose PDT and 15 out of 17 patients who received HSML could be evaluated at final visit. At final visit, 93% of the patients treated with half-dose PDT had complete resolution of SRF, compared with 53% of HSML-treated patients (p = 0.006). At final visit, the mean estimate increase in the PDT group compared with the HSML group was + 2.1 ETDRS letters, +0.15 dB for the retinal sensitivity and + 5.1 NEI-VFQ25 points (p = 0.103, p = 0.784 and p = 0.071, respectively). The mean estimated central retinal thickness in the half-dose PDT group was -7.0 µm compared with the HSML group (p = 0.566). The mean estimated subfoveal choroidal thickness in the half-dose PDT group was -16.6 µm compared with the HSML group (p = 0.359).
At 20 months after treatment, cCSC patients successfully treated with half-dose PDT are less likely to have recurrences of SRF compared with those successfully treated with HSML. However, functional outcomes did not differ.
描述 PLACE 试验中接受半剂量光动力疗法（PDT）或高密度亚阈值微脉冲激光（HSML）治疗后视网膜下液（SRF）完全消退的慢性中心性浆液性脉络膜视网膜病变（cCSC）患者的治疗结果和复发风险。
这项多中心前瞻性随访研究在 PLACE 试验完成后 1 年评估 cCSC 患者。结果包括：OCT 上 SRF 完全消退、早期治疗糖尿病性视网膜病变研究（ETDRS）字母的最佳矫正视力（BCVA）、微视野上的视网膜敏感性和视觉功能问卷（NEI-VFQ25）。
在最终随访时，可评估接受半剂量 PDT 治疗的 37 例患者中的 29 例和接受 HSML 治疗的 17 例患者中的 15 例。在最终随访时，接受半剂量 PDT 治疗的患者中有 93%的 SRF 完全消退，而接受 HSML 治疗的患者中有 53%（p=0.006）。在最终随访时，与 HSML 组相比，PDT 组的平均估计增加为+2.1 ETDRS 字母，视网膜敏感性增加+0.15dB，NEI-VFQ25 增加+5.1 分（p=0.103，p=0.784 和 p=0.071，分别）。半剂量 PDT 组的平均估计中央视网膜厚度为-7.0µm，而 HSML 组为-16.6µm（p=0.566）。半剂量 PDT 组的平均估计黄斑下脉络膜厚度为-16.6µm，而 HSML 组为-16.6µm（p=0.359）。
在治疗后 20 个月，与成功接受 HSML 治疗的患者相比，成功接受半剂量 PDT 治疗的 cCSC 患者发生 SRF 复发的可能性较低。然而，功能结果没有差异。
