Evaluating Photodynamic Therapy vs. Subthreshold Micropulse Laser for Central Serous Chorioretinopathy: A Retrospective Study

Tahm Spitznagel; Katrin Fasler; Jay Zoellin; Jeanne Martine Gunzinger; Chiara Sommer; Stephan Kinzl; Daniel Rudolf Muth; Ferhat Turgut; Amr Saad; Matthias Becker; Gabor Mark Somfai; Sandrine Zweifel

doi:10.1055/a-2542-4969

Klinische Monatsblätter für Augenheilkunde, Table of Contents

CC BY 4.0 · Klin Monbl Augenheilkd 2025; 242(04): 405-412
DOI: 10.1055/a-2542-4969

Klinische Studie

Evaluating Photodynamic Therapy vs. Subthreshold Micropulse Laser for Central Serous Chorioretinopathy: A Retrospective Study

Vergleich von photodynamischer Therapie mit Subthreshold-Micropulse-Lasertherapie bei Chorioretinopathia centralis serosa

Authors

Tahm Spitznagel^*

¹Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland

²Spross Research Institute, Zurich, Switzerland
Katrin Fasler^*

³Department of Ophthalmology, University Hospital Zurich, Switzerland
Jay Zoellin

¹Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland

²Spross Research Institute, Zurich, Switzerland
Jeanne Martine Gunzinger

³Department of Ophthalmology, University Hospital Zurich, Switzerland

⁴Department of Ophthalmology, Hunter New England Health, New Lambton, Australia
Chiara Sommer

¹Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland

²Spross Research Institute, Zurich, Switzerland
Stephan Kinzl

¹Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland

²Spross Research Institute, Zurich, Switzerland
Daniel Rudolf Muth

³Department of Ophthalmology, University Hospital Zurich, Switzerland

⁵Department of Clinical Neuroscience, Division of Eye and Vision, Karolinska Institiutet, Stockholm, Sweden
Ferhat Turgut

¹Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland

²Spross Research Institute, Zurich, Switzerland

⁶Augenklinik, Gutblick Research, Pfäffikon, Switzerland

⁷Department of Ophthalmology, Semmelweis University, Budapest, Hungary
Amr Saad

¹Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland

²Spross Research Institute, Zurich, Switzerland
Matthias Becker

¹Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland

²Spross Research Institute, Zurich, Switzerland

⁸Department of Ophthalmology, Heidelberg University, Heidelberg, Germany
Gabor Mark Somfai ^**

¹Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland

²Spross Research Institute, Zurich, Switzerland

⁷Department of Ophthalmology, Semmelweis University, Budapest, Hungary
Sandrine Zweifel^**

³Department of Ophthalmology, University Hospital Zurich, Switzerland

Abstract

Background Our study aims to compare the efficacy of half-dose photodynamic therapy with verteporfin (PDT) and subthreshold micropulse laser (SML) in patients with central serous chorioretinopathy (CSCR) with regards to subretinal fluid (SRF) resorption, visual acuity (VA), and central subfield thickness (CST).

Patients and Methods We conducted a retrospective multicentre clinical study at the Departments of Ophthalmology at the University Hospital Zurich and Stadtspital Zürich, Switzerland. The study included patients with acute and chronic CSCR who underwent PDT, SML, or both sequentially between June 1, 2020 and December 31, 2023. The primary outcome was the reduction in SRF at three and six months post-treatment. The secondary outcomes included change in CST VA at the same intervals.

Results A total of eighty-one eyes were analysed (33 PDT, 35 SML, thirteen combined). SRF reduction was statistically significant at both three and six months in the PDT (p < 0.001) and SML groups (p < 0.001). The combined treatment group showed a significant reduction in SRF only at six months (p = 0.001). At three months, PDT resulted in a significantly greater SRF reduction than the combined group.

Conclusions Both PDT and SML demonstrated improvements in SRF, CST and VA, with SML presenting as a comparable alternative, particularly in cases where access to verteporfin is limited.

Zusammenfassung

Zweck Ziel unserer Studie ist der Vergleich der Wirksamkeit der halbdosierten photodynamischen Therapie mit Verteporfin (PDT) und der Subthreshold-Micropulse-Lasertherapie (SML) bei Patienten mit Chorioretinitis centralis serosa (CSCR) hinsichtlich der Resorption subretinaler Flüssigkeit (SRF), des Visus (VA) und der zentralen Subfelddicke (CST).

Patienten und Methoden Eine retrospektive multizentrische klinische Studie wurde an den Augenkliniken des Universitätsspitals Zürich und des Stadtspitals Zürich, Schweiz, durchgeführt. Die Studie umfasste Patienten mit akuter und chronischer CSCR, die sich zwischen dem 1. Juni 2020 und dem 31. Dezember 2020 einer PDT, SML oder beiden Therapien unterzogen haben. Der primäre Endunkt war die Reduktion der SRF 3 und 6 Monate nach der Behandlung. Zu den sekundären Ergebnissen gehörte die Veränderung der CST und der VA zu denselben Zeitpunkten.

Ergebnisse Insgesamt wurden 81 Augen analysiert (33 PDT, 35 SML, 13 mit beidem). Die SRF war sowohl nach 3 als auch nach 6 Monaten in der PDT- (p < 0,001) und in der SML-Gruppe (p < 0,001) statistisch signifikant reduziert. Die kombinierte Behandlungsgruppe zeigte eine signifikante Verringerung der SRF nur nach 6 Monaten (p = 0.001). Nach 3 Monaten führte die PDT zu einer signifikant stärkeren Verringerung der SRF als die kombinierte Gruppe.

Konklusion Sowohl PDT als auch SML zeigten Verbesserungen der SRF, der CST und der VA, wobei SML insbesondere in Fällen mit begrenztem Zugang zu Verteporfin eine vergleichbare Alternative darstellt.

Keywords

CSCR - chorioretinitis centralis serosa - photodynamic therapy - subthreshold micropulse laser

Schlüsselwörter

Chorioretinitis centralis serosa - photodynamische Therapie - Subthreshold-Micropulse-Lasertherapie - CRCS

Full Text

References

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