Half-dose photodynamic therapy versus eplerenone in chronic central serous chorioretinopathy (SPECTRA): a randomized controlled trial

Abstract Purpose To compare the efficacy and safety between half-dose photodynamic therapy (PDT) and eplerenone for treating chronic central serous chorioretinopathy (cCSC). Design Multicenter, open-label, randomized controlled trial. Methods This investigator-initiated trial was conducted in 3 academic medical centers in the Netherlands. Eligible patients were randomized at a 1:1 ratio to receive either indocyanine green angiography-guided half-dose PDT or oral eplerenone for 12 weeks. Both anatomical and functional outcomes were evaluated at 3 months after the start of treatment. Results A total of 107 patients were randomly assigned to receive either half-dose PDT (n=53) or eplerenone treatment (n=54). Thirteen patients (3 in the PDT group and 10 in the eplerenone group) did not adhere to the study protocol. At the 3-month evaluation visit, 78% of patients in the PDT group had complete resolution of SRF, compared to only 17% of patients in the eplerenone group (p Conclusions Half-dose PDT is superior to oral eplerenone for cCSC with respect to both short-term safety and efficacy outcomes.