A randomized non-inferiority trial of 577nm subthreshold micropulse laser versus half-dose photodynamic therapy for acute central serous chorioretinopathy

Purpose: To compare the effectiveness of 577nm subthreshold micropulse laser (SML) with half-dose photodynamic therapy (Hd-PDT) for acute central serous chorioretinopathy (CSC). Method: A non-inferiority clinical trial was performed with a non-inferiority margin of eight letters. Sixty-eight eyes of...

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Main Authors: Lijun Zhou, Chuangxin Huang, Zijing Li, Tu Lu, Hongkun Zhao, Cong Li, Qifeng Cong, Jiandong Liang, Xiaojing Zhong, Ling Jin, Lin Lu, Chenjin Jin
Format: Article
Language:English
Published: Elsevier 2024-02-01
Series:Photodiagnosis and Photodynamic Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S157210002300635X
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author Lijun Zhou
Chuangxin Huang
Zijing Li
Tu Lu
Hongkun Zhao
Cong Li
Qifeng Cong
Jiandong Liang
Xiaojing Zhong
Ling Jin
Lin Lu
Chenjin Jin
author_facet Lijun Zhou
Chuangxin Huang
Zijing Li
Tu Lu
Hongkun Zhao
Cong Li
Qifeng Cong
Jiandong Liang
Xiaojing Zhong
Ling Jin
Lin Lu
Chenjin Jin
author_sort Lijun Zhou
collection DOAJ
description Purpose: To compare the effectiveness of 577nm subthreshold micropulse laser (SML) with half-dose photodynamic therapy (Hd-PDT) for acute central serous chorioretinopathy (CSC). Method: A non-inferiority clinical trial was performed with a non-inferiority margin of eight letters. Sixty-eight eyes of 68 patients with acute CSC were randomized to the Hd-PDT group or 577 nm SML group. Best-corrected visual acuity (BCVA ), the subretinal fluid (SRF), and the central foveal thickness (CFT) were evaluated at 6 months. Results: The visual acuity significantly improved from 70.38 ± 10.37 at baseline to 83.24 ± 3.03 at 6 months after treatment in the SML group (P < 0.001), from 71.09 ± 10.50 to 84.35 ± 2.09 in the PDT group (P < 0.001). SML was non-inferior to the PDT (mean difference: -0.41, 95% CI: -5.51 – 4.68, P = 0.0021). At the endpoint, CFT was significantly reduced in the two groups, but no statistical difference (P = 0.7694). The complete resolution of SRF reached 82.35% (28/34) in the SML group and 91.18% (31/34) in the PDT group, respectively,but no statistical difference (P = 0.3724). Conclusions: SML was non-inferiority to half-dose PDT in improving the visual acuity for CSC, and it is a viable alternative, especially when the verteporfin in PDT is unavailable.
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spelling doaj-art-ee6429ab691b49b7a85fa451bc0dbda42024-12-11T05:55:15ZengElsevierPhotodiagnosis and Photodynamic Therapy1572-10002024-02-0145103908A randomized non-inferiority trial of 577nm subthreshold micropulse laser versus half-dose photodynamic therapy for acute central serous chorioretinopathyLijun Zhou0Chuangxin Huang1Zijing Li2Tu Lu3Hongkun Zhao4Cong Li5Qifeng Cong6Jiandong Liang7Xiaojing Zhong8Ling Jin9Lin Lu10Chenjin Jin11State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, China; Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, ChinaThe Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming, Yunnan Province, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, ChinaDepartment of Ophthalmology, Third People's Hospital of Dalian, Dalian Medical University, Dalian, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, China; Correspondence author.Purpose: To compare the effectiveness of 577nm subthreshold micropulse laser (SML) with half-dose photodynamic therapy (Hd-PDT) for acute central serous chorioretinopathy (CSC). Method: A non-inferiority clinical trial was performed with a non-inferiority margin of eight letters. Sixty-eight eyes of 68 patients with acute CSC were randomized to the Hd-PDT group or 577 nm SML group. Best-corrected visual acuity (BCVA ), the subretinal fluid (SRF), and the central foveal thickness (CFT) were evaluated at 6 months. Results: The visual acuity significantly improved from 70.38 ± 10.37 at baseline to 83.24 ± 3.03 at 6 months after treatment in the SML group (P < 0.001), from 71.09 ± 10.50 to 84.35 ± 2.09 in the PDT group (P < 0.001). SML was non-inferior to the PDT (mean difference: -0.41, 95% CI: -5.51 – 4.68, P = 0.0021). At the endpoint, CFT was significantly reduced in the two groups, but no statistical difference (P = 0.7694). The complete resolution of SRF reached 82.35% (28/34) in the SML group and 91.18% (31/34) in the PDT group, respectively,but no statistical difference (P = 0.3724). Conclusions: SML was non-inferiority to half-dose PDT in improving the visual acuity for CSC, and it is a viable alternative, especially when the verteporfin in PDT is unavailable.http://www.sciencedirect.com/science/article/pii/S157210002300635XSubthreshold micropulse laserHalf-dose photodynamic therapyCentral serous chorioretinopathyPhotodynamic therapy
spellingShingle Lijun Zhou
Chuangxin Huang
Zijing Li
Tu Lu
Hongkun Zhao
Cong Li
Qifeng Cong
Jiandong Liang
Xiaojing Zhong
Ling Jin
Lin Lu
Chenjin Jin
A randomized non-inferiority trial of 577nm subthreshold micropulse laser versus half-dose photodynamic therapy for acute central serous chorioretinopathy
Photodiagnosis and Photodynamic Therapy
Subthreshold micropulse laser
Half-dose photodynamic therapy
Central serous chorioretinopathy
Photodynamic therapy
title A randomized non-inferiority trial of 577nm subthreshold micropulse laser versus half-dose photodynamic therapy for acute central serous chorioretinopathy
title_full A randomized non-inferiority trial of 577nm subthreshold micropulse laser versus half-dose photodynamic therapy for acute central serous chorioretinopathy
title_fullStr A randomized non-inferiority trial of 577nm subthreshold micropulse laser versus half-dose photodynamic therapy for acute central serous chorioretinopathy
title_full_unstemmed A randomized non-inferiority trial of 577nm subthreshold micropulse laser versus half-dose photodynamic therapy for acute central serous chorioretinopathy
title_short A randomized non-inferiority trial of 577nm subthreshold micropulse laser versus half-dose photodynamic therapy for acute central serous chorioretinopathy
title_sort randomized non inferiority trial of 577nm subthreshold micropulse laser versus half dose photodynamic therapy for acute central serous chorioretinopathy
topic Subthreshold micropulse laser
Half-dose photodynamic therapy
Central serous chorioretinopathy
Photodynamic therapy
url http://www.sciencedirect.com/science/article/pii/S157210002300635X
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