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Outcomes were evaluated at 24\u2009months, including the primary outcome measure of complete resolution of subretinal fluid (SRF) on optical coherence tomography (OCT) and the secondary outcome measures best\u2010corrected visual acuity (BCVA), retinal and foveal sensitivity on microperimetry and the National Eye Institute Visual Functioning Questionnaire 25 (NEI\u2010VFQ25) score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, 107 patients were included, of which 80 patients attended the final visit at 24\u2009months: 40 had been randomized to primary treatment with half\u2010dose PDT and 40 to eplerenone. In the eplerenone group, as many as 36\/40 (90%) needed crossover treatment at 3\u2009months with half\u2010dose PDT due to persistent SRF, compared to 8\/40 (20%) in the half\u2010dose PDT group. At the final visit, complete SRF resolution was observed in 32\/40 (80%) who were primarily treated with half\u2010dose PDT and in 35\/40 (88%) who received primary eplerenone treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.609). There were no significant differences in terms of BCVA, foveal sensitivity, retinal sensitivity and NEI\u2010VFQ25 score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides evidence for the long\u2010term efficacy of half\u2010dose PDT in resolving SRF and improving functional outcomes in cCSC. Even when patients initially received eplerenone treatment that did not result in complete SRF resolution, crossover treatment with half\u2010dose PDT led to similar (long\u2010term) group outcomes compared to half\u2010dose PDT as initial treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.70106","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T07:59:38Z","timestamp":1770883178000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term follow\u2010up of chronic central serous chorioretinopathy patients receiving oral eplerenone and half\u2010dose photodynamic therapy in the SPECTRA trial: SPECTRA trial report No. 4"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3106-0455","authenticated-orcid":false,"given":"Helena M. A.","family":"Feenstra","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issam","family":"El Mansori","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9589-602X","authenticated-orcid":false,"given":"Thomas J.","family":"van Rijssen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roula","family":"Tsonaka","sequence":"additional","affiliation":[{"name":"Department of Biomedical Data Sciences Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9708-2898","authenticated-orcid":false,"given":"Roselie M. H.","family":"Diederen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Amsterdam University Medical Center, University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carel B.","family":"Hoyng","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinier O.","family":"Schlingemann","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Amsterdam University Medical Center, University of Amsterdam  Amsterdam the Netherlands"},{"name":"Department of Ophthalmology Fondation Asile des Aveugles, Jules\u2010Gonin Eye Hospital, University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6737-7932","authenticated-orcid":false,"given":"Camiel J. 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