Abstract

We thank the authors for their detailed appraisal and positive comments about our study.1van Dijk E.H.C. Fauser S. Breukink M.B. et al.Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy: the PLACE trial.Ophthalmology. 2018; 125: 1547-1555Abstract Full Text Full Text PDF PubMed Scopus (133) Google Scholar In our study, we have included patients who had typical findings of chronic central serous chorioretinopathy (cCSC) on multimodal imaging. In this first PLACE trial report, we focused on the primary and secondary endpoints. Our study was designed primarily to assess a morphologic endpoint, namely, the complete resolution of subretinal fluid, which is a prerequisite for preserving and/or restoring function. With regard to the functional endpoints, microperimetry may be a more sensitive and earlier functional endpoint than best-corrected visual acuity, given that the recovery of best-corrected visual acuity can be delayed in cCSC after treatment.2Scholz P. Ersoy L. Boon C.J. Fauser S. Subthreshold micropulse laser (577 nm) treatment in chronic central serous chorioretinopathy.Ophthalmologica. 2015; 234: 189-194Crossref PubMed Scopus (50) Google Scholar Both the percentage of patients with complete resolution of subretinal fluid and the increase in retinal sensitivity on microperimetry was significantly higher in the patients who received half-dose photodynamic therapy compared with high-density subthreshold micropulse laser treatment. This was the case for both the first control visit and the final follow-up visit. We agree with the authors that photodynamic therapy currently represents the first-line choice for the treatment of cCSC patients.3Mehta P.H. Meyerle C. Sivaprasad S. et al.Preferred practice pattern in central serous chorioretinopathy.Br J Ophthalmol. 2017; 101: 587-590Crossref PubMed Scopus (28) Google Scholar However, this type of treatment may also be the first-line treatment of choice in patients with severe CSC. On this subject, we recently published an article, in which the outcome of treatment for patients with severe CSC proved to be roughly similar to findings that have been previously published for cCSC patients: 76% of treated eyes had no subretinal fluid on OCT at the final visit.4Mohabati D. van Rijssen T.J. van Dijk E.H. et al.Clinical characteristics and long-term visual outcome of severe phenotypes of chronic central serous chorioretinopathy.Clin Ophthalmol. 2018; 12: 1061-1070Crossref PubMed Scopus (31) Google Scholar However, in upcoming studies we will further evaluate CSC subgroups and anatomic parameters, and we thank the authors for their valuable suggestions in this regard. Re: van Dijk et al: Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy: The PLACE trial (Ophthalmology. 2018;125:1547-1555)OphthalmologyVol. 126Issue 1PreviewWe read with interest the article by van Dijk et al1 concerning the effects of half-dose photodynamic therapy (PDT) and high-density subthreshold micropulse laser for the treatment of patients with chronic central serous chorioretinopathy (cCSC). The authors concluded that half-dose PDT is superior to high-density subthreshold micropulse laser (HSML) for treating cCSC, leading to a significantly higher proportion of patients with complete resolution of subretinal fluid (SRF) and functional improvement. Full-Text PDF

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