TY - JOUR
T1 - Long-term follow-up of chronic central serous chorioretinopathy patients after primary treatment of oral eplerenone or half-dose photodynamic therapy and crossover treatment
T2 - SPECTRA trial report No. 3
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 - Hoyng, Carel B.
AU - Schlingemann, Reinier O.
AU - Boon, Camiel J. F.
N1 - Funding Information: H.M.A. Feenstra was supported by the Blindenhulp Fellowship from Stichting Blindenhulp (The Hague, the Netherlands). This research was also 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 (CJFB); and the Netherlands Organization for Scientific Research (VENI grant to CJFB). Publisher Copyright: © 2022, The Author(s).
PY - 2023/3
Y1 - 2023/3
N2 - Purpose: Comparing anatomic and functional efficacy and safety of primary treatment with either half-dose photodynamic therapy (PDT) or oral eplerenone, or crossover treatment in chronic central serous chorioretinopathy patients. Methods: After the SPECTRA trial baseline visit, patients were randomized to either half-dose PDT or eplerenone and received crossover treatment if persistent subretinal fluid (SRF) on optical coherence tomography (OCT) was present at first follow-up (at 3 months). Presence of SRF and best-corrected visual acuity (BCVA) was evaluated at 12 months. Results: Out of the 90 patients evaluated at 12 months, complete SRF resolution was present on OCT in 43/48 (89.6%) of patients who were primarily randomized to half-dose PDT and in 37/42 (88.1%) who were primarily randomized to eplerenone. Out of the 42 patients that were primarily randomized to eplerenone, 35 received crossover treatment with half-dose PDT. The BCVA improved significantly more at 12 months in patients who had received primary half-dose PDT as compared to the primary eplerenone group (p = 0.030). Conclusions: Twelve months after baseline visit, most patients treated with half-dose PDT (either primary or crossover treatment) still had complete SRF resolution. The long-term BCVA in patients who receive primary half-dose PDT is better than in patients in whom PDT is delayed due to initial eplerenone treatment with persistent SRF.
AB - Purpose: Comparing anatomic and functional efficacy and safety of primary treatment with either half-dose photodynamic therapy (PDT) or oral eplerenone, or crossover treatment in chronic central serous chorioretinopathy patients. Methods: After the SPECTRA trial baseline visit, patients were randomized to either half-dose PDT or eplerenone and received crossover treatment if persistent subretinal fluid (SRF) on optical coherence tomography (OCT) was present at first follow-up (at 3 months). Presence of SRF and best-corrected visual acuity (BCVA) was evaluated at 12 months. Results: Out of the 90 patients evaluated at 12 months, complete SRF resolution was present on OCT in 43/48 (89.6%) of patients who were primarily randomized to half-dose PDT and in 37/42 (88.1%) who were primarily randomized to eplerenone. Out of the 42 patients that were primarily randomized to eplerenone, 35 received crossover treatment with half-dose PDT. The BCVA improved significantly more at 12 months in patients who had received primary half-dose PDT as compared to the primary eplerenone group (p = 0.030). Conclusions: Twelve months after baseline visit, most patients treated with half-dose PDT (either primary or crossover treatment) still had complete SRF resolution. The long-term BCVA in patients who receive primary half-dose PDT is better than in patients in whom PDT is delayed due to initial eplerenone treatment with persistent SRF.
KW - Central serous chorioretinopathy
KW - Eplerenone
KW - Long-term follow-up
KW - Mineralocorticoid receptor antagonist
KW - Photodynamic therapy
KW - SPECS
KW - SPECTRA trial
UR - http://www.scopus.com/inward/record.url?scp=85139510388&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00417-022-05836-x
DO - https://doi.org/10.1007/s00417-022-05836-x
M3 - Article
C2 - 36202933
SN - 0721-832X
VL - 261
SP - 659
EP - 668
JO - Graefe's archive for clinical and experimental ophthalmology
JF - Graefe's archive for clinical and experimental ophthalmology
IS - 3
ER -