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慢性中心性浆液性脉络膜视网膜病变的光动力疗法

Photodynamic therapy for chronic central serous chorioretinopathy.

作者信息

Cardillo Piccolino Felice, Eandi Chiara M, Ventre Luca, Rigault de la Longrais Roberta C, Grignolo Federico M

机构信息

Institute of Ophthalmology, Department of Clinical Physiotherapy, University of Torino, Turin, Italy.

出版信息

Retina. 2003 Dec;23(6):752-63. doi: 10.1097/00006982-200312000-00002.

Abstract

PURPOSE

To determine whether photodynamic therapy (PDT) is effective for treatment of chronic central serous chorioretinopathy (CSC).

METHODS

Sixteen eyes with chronic CSC and macular detachment documented by optical coherence tomography (OCT) received PDT guided by indocyanine green (ICG) angiography according to the parameters outlined in the TAP Study. One or more laser spots were applied to the areas of choroidal vascular hyperpermeability that corresponded to retinal pigment epithelium decompensation. Patients were observed for 6 to 12 months. Two PDT sessions 1 month apart were performed on 2 eyes. Examinations included visual acuity measurement, fundus biomicroscopy, fluorescein and ICG angiography, and OCT.

RESULTS

Macular exudation resolved completely in 13 eyes (81%) and partially regressed in 3. Choriocapillaris hypoperfusion was shown by ICG angiography for several months at the site of PDT application. Visual acuity improved 1 to 4 lines in 11 eyes and was unchanged in 5 eyes.

CONCLUSIONS

ICG-guided PDT performed according to the parameters outlined by the TAP Study seems effective for treating chronic CSC. Further studies are needed to verify treatment safety and the time and rate of recurrences.

摘要

目的

确定光动力疗法(PDT)治疗慢性中心性浆液性脉络膜视网膜病变(CSC)是否有效。

方法

16只经光学相干断层扫描(OCT)记录为慢性CSC且伴有黄斑脱离的眼睛,根据TAP研究中概述的参数,接受吲哚菁绿(ICG)血管造影引导下的PDT治疗。对与视网膜色素上皮失代偿相对应的脉络膜血管高通透性区域应用一个或多个激光光斑。对患者进行6至12个月的观察。对2只眼睛进行了间隔1个月的两次PDT治疗。检查包括视力测量、眼底生物显微镜检查、荧光素和ICG血管造影以及OCT。

结果

13只眼睛(81%)的黄斑渗出完全消退,3只眼睛部分消退。ICG血管造影显示在PDT治疗部位的脉络膜毛细血管灌注不足持续了数月。11只眼睛的视力提高了1至4行,5只眼睛的视力无变化。

结论

根据TAP研究中概述的参数进行的ICG引导下的PDT似乎对治疗慢性CSC有效。需要进一步研究以验证治疗安全性以及复发时间和复发率。

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