Efficacy of half-dose photodynamic therapy versus high-density subthreshold micropulse laser for treating pigment epithelial detachments in chronic central serous chorioretinopathy: PLACE trial report No. 5

Author: Helena Feenstra (Netherlands)

Co-authors: Carel Hoyng, Eric Souied, Susan Downes, Sascha Fauser, Elon van Dijk, Camiel Boon

Purpose

To compare the effect of half-dose photodynamic therapy (PDT) and high-density subthreshold micropulse laser (HSML) treatment on retinal pigment epithelial detachments (PEDs) in chronic central serous chorioretinopathy (cCSC).

Setting/Venue

This study included data from the PLACE trial, a prospective randomized controlled trial comparing half-dose PDT and HSML treatment in cCSC. Data of patients from 5 different academic medical centers located in Leiden (The Netherlands), Nijmegen (The Netherlands), Cologne (Germany), Paris (France) and Oxford (United Kingdom) were included in this study.

Methods

Main outcome measurements were changes in both the foveal PED and highest PED within the macula on optical coherence tomography at baseline compared to first evaluation visit (at 6-8 weeks) and final evaluation visit (at 7-8 months).

Results

At baseline, a macular PED was detected in 76.9% (123/160) of patients, and a PED within 1500 µm from the foveal center in 37.5% (60/160) of patients. In the half-dose PDT arm (61 patients), there was a significantly higher decrease in the highest macular PED compared to the HSML treatment arm (62 patients), both at first and final evaluation visit (p<0.001 and p=0.012, respectively). The decrease of highest foveal PED was significant at first visit (p=0.025).

Conlusions

Half-dose PDT is superior to HSML treatment with regard to a statistically significant reduction in the height of macular PEDs in active cCSC. These findings may also have implications for other diseases within the pachychoroid disease spectrum that can present with PEDs.

Financial Disclosure

Financial Disclosure: Sascha Fauser: Employee (Hoffman-La Roche, Basel, Switzerland). No financial disclosures exist for any of the other authors.