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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
Tahm Spitznagel   *
1   Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland
2   Spross Research Institute, Zurich, Switzerland
,
Katrin Fasler   *
3   Department of Ophthalmology, University Hospital Zurich, Switzerland
,
Jay Zoellin
1   Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland
2   Spross Research Institute, Zurich, Switzerland
,
Jeanne Martine Gunzinger
3   Department of Ophthalmology, University Hospital Zurich, Switzerland
4   Department of Ophthalmology, Hunter New England Health, New Lambton, Australia
,
Chiara Sommer
1   Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland
2   Spross Research Institute, Zurich, Switzerland
,
Stephan Kinzl
1   Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland
2   Spross Research Institute, Zurich, Switzerland
,
Daniel Rudolf Muth
3   Department of Ophthalmology, University Hospital Zurich, Switzerland
5   Department of Clinical Neuroscience, Division of Eye and Vision, Karolinska Institiutet, Stockholm, Sweden
,
Ferhat Turgut
1   Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland
2   Spross Research Institute, Zurich, Switzerland
6   Augenklinik, Gutblick Research, Pfäffikon, Switzerland
7   Department of Ophthalmology, Semmelweis University, Budapest, Hungary
,
Amr Saad 
1   Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland
2   Spross Research Institute, Zurich, Switzerland
,
Matthias Becker
1   Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland
2   Spross Research Institute, Zurich, Switzerland
8   Department of Ophthalmology, Heidelberg University, Heidelberg, Germany
,
Gabor Mark Somfai    **
1   Department of Ophthalmology, Stadtspital Zürich Triemli, Zurich, Switzerland
2   Spross Research Institute, Zurich, Switzerland
7   Department of Ophthalmology, Semmelweis University, Budapest, Hungary
,
Sandrine Zweifel   **
3   Department of Ophthalmology, University Hospital Zurich, Switzerland
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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

* Shared first authorship.


** Shared last authorship.




Publication History

Received: 27 October 2024

Accepted: 24 December 2024

Article published online:
16 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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