TY - JOUR
T1 - Half-Dose Photodynamic Therapy Versus Eplerenone in Chronic Central Serous Chorioretinopathy (SPECTRA)
T2 - A Randomized Controlled Trial
AU - van Rijssen, Thomas J.
AU - van Dijk, Elon H. C.
AU - Tsonaka, Roula
AU - Feenstra, Helena M. A.
AU - Dijkman, Greet
AU - Peters, Petrus J. H.
AU - Diederen, Roselie M. H.
AU - Hoyng, Carel B.
AU - Schlingemann, Reinier O.
AU - Boon, Camiel J. F.
N1 - Funding Information: Funding/Support: This research was 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; Oogfonds, which contributed through UitZicht (Delft, the Netherlands); Rotterdamse Stichting Blindenbelangen (Rotterdam, the Netherlands); Stichting Leids Oogheelkundig Ondersteuningsfonds (Leiden, the Netherlands); Haagse Stichting Blindenhulp (The Hague, the Netherlands); Stichting Ooglijders (Rotterdam, the Netherlands); the Gisela Thier Fellowship of Leiden University, Leiden, the Netherlands (to CB); and the Netherlands Organization for Scientific Research (VENI grant to CB). Publisher Copyright: © 2021
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Purpose: To compare the efficacy and safety between half-dose photodynamic therapy (PDT) and eplerenone therapy for treating chronic central serous chorioretinopathy (cCSC). Design: This was a multicenter, open-label, randomized controlled trial. Methods: This investigator-initiated trial was conducted in 3 academic medical centers in the Netherlands. Eligible patients were randomized at a 1:1 ratio to receive either indocyanine green angiography-guided half-dose PDT or oral eplerenone for 12 weeks. Both anatomical and functional outcomes were evaluated at 3 months after the start of treatment. Results: A total of 107 patients were randomly assigned to receive either half-dose PDT (n = 53) or eplerenone treatment (n = 54). Thirteen patients (3 in the PDT group and 10 in the eplerenone group) did not adhere to the study protocol. At the 3-month evaluation visit, 78% of patients in the PDT group had complete resolution of subretinal fluid accumulation compared to only 17% of patients in the eplerenone group (P < .001). Mean best-corrected visual acuity in Early Treatment of Diabetic Retinopathy Study letters at the 3-month evaluation visit was 83.7 ± 10.8 and 82.8 ± 9.0 in the PDT and eplerenone groups, respectively (P = .555). In addition, mean retinal sensitivity on microperimetry was 25.4 ± 3.4 dB and 23.9 ± 4.0 dB in the PDT and eplerenone groups, respectively (P = .041). Finally, mean vision-related quality of life scores were 87.2 ± 8.5 and 83.8 ± 12.1 in the PDT and eplerenone groups, respectively (P = .094). Three patients (6%) in the PDT group experienced adverse events during the study compared to 18 patients (33%) in the eplerenone group. Conclusions: Half-dose PDT is superior to oral eplerenone for cCSC with respect to both short-term safety and efficacy outcomes.
AB - Purpose: To compare the efficacy and safety between half-dose photodynamic therapy (PDT) and eplerenone therapy for treating chronic central serous chorioretinopathy (cCSC). Design: This was a multicenter, open-label, randomized controlled trial. Methods: This investigator-initiated trial was conducted in 3 academic medical centers in the Netherlands. Eligible patients were randomized at a 1:1 ratio to receive either indocyanine green angiography-guided half-dose PDT or oral eplerenone for 12 weeks. Both anatomical and functional outcomes were evaluated at 3 months after the start of treatment. Results: A total of 107 patients were randomly assigned to receive either half-dose PDT (n = 53) or eplerenone treatment (n = 54). Thirteen patients (3 in the PDT group and 10 in the eplerenone group) did not adhere to the study protocol. At the 3-month evaluation visit, 78% of patients in the PDT group had complete resolution of subretinal fluid accumulation compared to only 17% of patients in the eplerenone group (P < .001). Mean best-corrected visual acuity in Early Treatment of Diabetic Retinopathy Study letters at the 3-month evaluation visit was 83.7 ± 10.8 and 82.8 ± 9.0 in the PDT and eplerenone groups, respectively (P = .555). In addition, mean retinal sensitivity on microperimetry was 25.4 ± 3.4 dB and 23.9 ± 4.0 dB in the PDT and eplerenone groups, respectively (P = .041). Finally, mean vision-related quality of life scores were 87.2 ± 8.5 and 83.8 ± 12.1 in the PDT and eplerenone groups, respectively (P = .094). Three patients (6%) in the PDT group experienced adverse events during the study compared to 18 patients (33%) in the eplerenone group. Conclusions: Half-dose PDT is superior to oral eplerenone for cCSC with respect to both short-term safety and efficacy outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85118511297&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ajo.2021.06.020
DO - https://doi.org/10.1016/j.ajo.2021.06.020
M3 - Article
C2 - 34214454
SN - 0002-9394
VL - 233
SP - 101
EP - 110
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -