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Low-fluence photodynamic therapy versus ranibizumab for chronic central serous chorioretinopathy : one-year results of a randomized trial . PURPOSE To compare the efficacy and safety between low-fluence photodynamic therapy ( PDT ) and the intravitreal ranibizumab in the treatment of chronic central serous chorioretinopathy ( CSC ) . DESIGN Prospective , randomized , single-center , parallel-arm , controlled trial . PARTICIPANTS Thirty-four eyes of 32 patients with chronic CSC with > 6 months ' duration of symptoms or recurrent CSC were randomly placed into the low-fluence PDT group ( n = 18 ) or the ranibizumab group ( n = 16 ) . INTERVENTION The patients underwent a single session of low-fluence PDT or 3 consecutive monthly injections of ranibizumab . Rescue treatment was available from month 3 if the subretinal fluid ( SRF ) persisted or recurred after primary treatment ; low-fluence PDT was given to the ranibizumab group and intravitreal ranibizumab to the low-fluence PDT group . MAIN OUTCOME MEASURES The primary outcome was the proportion of eyes with complete resolution of SRF without rescue treatment . Secondary outcomes included the mean changes in logarithm of the minimum angle of resolution best-corrected visual acuity ( BCVA ) , central retinal thickness ( CRT ) , and angiographic findings from baseline to 12 months . RESULTS At month 12 , 16 eyes ( 88.9 % ) of the low-fluence PDT group maintained complete resolution of SRF without rescue treatment versus 2 eyes ( 12.5 % ) in the ranibizumab group ( P < 0.001 ) . Two eyes ( 11.1 % ) in the low-fluence PDT group and 11 eyes ( 68.8 % ) in the ranibizumab group met the criteria for rescue treatment ( P = 0.001 ) . In the low-fluence PDT group , the mean decrease in CRT from baseline was significantly greater than that in the ranibizumab group until month 6 ( P < 0.05 ) , but the differences became insignificant thereafter . The improvement in BCVA from baseline was superior in the low-fluence PDT group to that in the ranibizumab group , but the differences were not statistically significant except at month 3 ( P = 0.025 ) . On indocyanine green angiography , a significantly greater proportion of the low-fluence PDT group ( 16 eyes ; 88.9 % ) showed a marked reduction in choroidal hyperpermeability after primary treatment than that of the ranibizumab group ( 0 eyes ; P < 0.001 ) . No serious adverse events related to the drugs or procedures were observed . CONCLUSIONS This study represents the overall superiority of low-fluence PDT compared with intravitreal ranibizumab in the treatment of chronic CSC .
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Intervention_Physical
Low-fluence photodynamic therapy
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Intervention_Pharmacological
ranibizumab
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Intervention_Physical
low-fluence PDT
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Intervention_Pharmacological
3 consecutive monthly injections of ranibizumab
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Intervention_Control
Rescue treatment
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Outcome_Other
efficacy
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Outcome_Other
safety
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Outcome_Physical
proportion of eyes with complete resolution of SRF
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Outcome_Physical
mean changes in logarithm of the minimum angle of resolution best-corrected visual acuity ( BCVA )
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Outcome_Physical
central retinal thickness ( CRT )
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Outcome_Physical
angiographic findings
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Outcome_Physical
resolution of SRF without rescue treatment
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Outcome_Physical
mean decrease in CRT
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Outcome_Physical
improvement in BCVA
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Outcome_Physical
choroidal hyperpermeability
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Outcome_Adverse-effects
serious adverse events
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Participant_Condition
chronic central serous chorioretinopathy :