TY - JOUR
T1 - Crossover to Half-Dose Photodynamic Therapy or Eplerenone in Chronic Central Serous Chorioretinopathy Patients
AU - Feenstra, Helena M. A.
AU - van Dijk, Elon H. C.
AU - van Rijssen, Thomas J.
AU - Tsonaka, Roula
AU - Diederen, Roselie M. H.
AU - Schlingemann, Reinier O.
AU - Hoyng, Carel B.
AU - Boon, Camiel J. F.
N1 - Funding Information: The authors have made the following disclosure(s): H.M.A.F.: Support – the Blindenhulp Fellowship from Stichting Blindenhulp (The Hague, the Netherlands).Supported by the following foundations: 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); Stichting Ooglijders (Rotterdam, the Netherlands); the Gisela Thier Fellowship of Leiden University, Leiden, the Netherlands (CB); and the Netherlands Organization for Scientific Research (VENI grant to CB). The funding organizations had no role in the design or conduct of this research. They provided unrestricted grants. Obtained funding: Boon; Study was performed as part of the authors' regular employment duties. No additional funding was provided. Funding Information: Supported by the following foundations: 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); Stichting Ooglijders (Rotterdam, the Netherlands); the Gisela Thier Fellowship of Leiden University , Leiden, the Netherlands (CB); and the Netherlands Organization for Scientific Research (VENI grant to CB). Publisher Copyright: © 2022
PY - 2022/10
Y1 - 2022/10
N2 - Purpose: To compare the efficacy and safety of crossover treatment to half-dose photodynamic therapy (PDT) and eplerenone treatment after the failure of primary treatment in patients with chronic central serous chorioretinopathy (cCSC). Design: Multicenter crossover clinical trial. Subjects: At 3 months after the baseline visit of the SPECTRA (Half-Dose Photodynamic Therapy Versus Eplerenone: Treatment Trial for Chronic Central Serous Chorioretinopathy) randomized controlled trial, either half-dose PDT or eplerenone treatment was evaluated for each patient, and patients who still demonstrated subretinal fluid (SRF) were included in the current study, the SPECS (Central Serous Chorioretinopathy Treated with Half-Dose PDT or Eplerenone Crossover Study) trial. Methods: At the baseline visits for the current SPECS trial, crossover treatment was performed for patients who still demonstrated SRF. These patients received either half-dose PDT or oral eplerenone for 12 weeks. Both anatomic and functional parameters were evaluated 3 months after crossover treatment. Main Outcome Measures: Complete resolution of SRF on OCT. Results: Forty-nine patients were included in the SPECS trial (38 received primary eplerenone treatment; 11 received half-dose PDT). At 3 months after crossover treatment, 32 of 37 (86.5%) in the crossover to half-dose PDT group and 2 of 9 (22.2%) in the crossover to eplerenone group had complete SRF resolution (P = 0.030). The mean foveal sensitivity increased significantly more in the crossover to half-dose PDT group (mean, +3.08 dB) compared with the crossover to eplerenone group (mean, −0.27 dB; P = 0.009). Conclusions: Patients with cCSC with the persistence of SRF after primary eplerenone treatment can benefit from half-dose PDT, which can induce a relatively fast and complete SRF resolution, along with an improvement in foveal sensitivity.
AB - Purpose: To compare the efficacy and safety of crossover treatment to half-dose photodynamic therapy (PDT) and eplerenone treatment after the failure of primary treatment in patients with chronic central serous chorioretinopathy (cCSC). Design: Multicenter crossover clinical trial. Subjects: At 3 months after the baseline visit of the SPECTRA (Half-Dose Photodynamic Therapy Versus Eplerenone: Treatment Trial for Chronic Central Serous Chorioretinopathy) randomized controlled trial, either half-dose PDT or eplerenone treatment was evaluated for each patient, and patients who still demonstrated subretinal fluid (SRF) were included in the current study, the SPECS (Central Serous Chorioretinopathy Treated with Half-Dose PDT or Eplerenone Crossover Study) trial. Methods: At the baseline visits for the current SPECS trial, crossover treatment was performed for patients who still demonstrated SRF. These patients received either half-dose PDT or oral eplerenone for 12 weeks. Both anatomic and functional parameters were evaluated 3 months after crossover treatment. Main Outcome Measures: Complete resolution of SRF on OCT. Results: Forty-nine patients were included in the SPECS trial (38 received primary eplerenone treatment; 11 received half-dose PDT). At 3 months after crossover treatment, 32 of 37 (86.5%) in the crossover to half-dose PDT group and 2 of 9 (22.2%) in the crossover to eplerenone group had complete SRF resolution (P = 0.030). The mean foveal sensitivity increased significantly more in the crossover to half-dose PDT group (mean, +3.08 dB) compared with the crossover to eplerenone group (mean, −0.27 dB; P = 0.009). Conclusions: Patients with cCSC with the persistence of SRF after primary eplerenone treatment can benefit from half-dose PDT, which can induce a relatively fast and complete SRF resolution, along with an improvement in foveal sensitivity.
KW - Central serous chorioretinopathy
KW - Eplerenone
KW - Half-dose photodynamic therapy
KW - Mineralocorticoid receptor agonist
UR - http://www.scopus.com/inward/record.url?scp=85131385023&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.oret.2022.04.014
DO - https://doi.org/10.1016/j.oret.2022.04.014
M3 - Article
C2 - 35470085
SN - 2468-6530
VL - 6
SP - 930
EP - 938
JO - Ophthalmology Retina
JF - Ophthalmology Retina
IS - 10
ER -