Sutter F K, Kurz-Levin M M, Scherrer M, Barthelmes D, Fleischhauer J C, Helbig H
Augenklinik, Universitätsspital, Zürich, Switzerland.
Klin Monbl Augenheilkd. 2007 Apr;224(4):297-9. doi: 10.1055/s-2007-962949.
Due to the high risk of RPE tears PDT is usually not performed in eyes with serous RPE detachments (sRPED). For this reason this subform of exudative AMD was so far untreatable.
We report on a prospective uncontrolled observational case series. 20 eyes of 20 patients with subfoveal sRPED demonstrated by OCT were treated between June 2005 and April 2006 with intravitreal triamcinolone acetonide (IVTA). In 15 cases there was a primary sRPED, in 5 cases it had developed after one or more sessions of photodynamic therapy with Visudyne.
There was a trend for better average visual acuity in the group with primary sRPED from 0.73 logMAR (0.19 Snellen equivalent) at baseline (n = 15) to 0.68 logMAR (0.21 Snellen) after one month (n = 15) (p = 0.19) and to 0.60 logMAR (0.25 Snellen) after three months (n = 14) (p = 0.41). The maximal height of sRPED decreased to an average of 35.3 % after one month (n = 15) and increased again to 56.9 % after 3 months (n = 14). One patient was lost to follow-up. In the group of eyes with sRPED after PDT, one eye developed an RPE tear with severe vision loss two weeks after IVTA. In the remaining four eyes average visual acuity improved from 0.90 logMAR (0.13 Snellen) at baseline to 0.73 logMAR (0.19 Snellen) after one month and to 0.80 logMAR (0.16 Snellen) after 3 months. Complete resolution of sRPED was observed in 8/20 eyes (4/5 eyes with sRPED after PDT and 4/15 eyes with primary sRPED).
IVTA seems to be a therapeutic option in otherwise untreatable eyes with sRPED.
由于视网膜色素上皮（RPE）撕裂的高风险，光动力疗法（PDT）通常不在伴有浆液性RPE脱离（sRPED）的眼中进行。因此，这种渗出性年龄相关性黄斑变性（AMD）的亚型迄今为止无法治疗。
我们报告了一项前瞻性非对照观察性病例系列研究。2005年6月至2006年4月期间，对20例经光学相干断层扫描（OCT）证实为黄斑下sRPED的患者的20只眼进行了玻璃体内注射曲安奈德（IVTA）治疗。15例为原发性sRPED，5例是在接受一次或多次维速达尔光动力治疗后发生的。
原发性sRPED组平均视力有改善趋势，从基线时的0.73 logMAR（0.19 Snellen等效值）（n = 15），1个月后变为0.68 logMAR（0.21 Snellen）（n = 15）（p = 0.19），3个月后变为0.60 logMAR（0.25 Snellen）（n = 14）（p = 0.41）。sRPED的最大高度在1个月后平均下降至35.3%（n = 15），3个月后又升至56.9%（n = 14）。1例患者失访。在PDT后发生sRPED的眼组中，1只眼在IVTA治疗两周后发生RPE撕裂并伴有严重视力丧失。其余4只眼的平均视力从基线时的0.90 logMAR（0.13 Snellen）改善至1个月后的0.73 logMAR（0.19 Snellen），3个月后为0.80 logMAR（0.16 Snellen）。20只眼中有8只（PDT后发生sRPED的5只眼中的4只和原发性sRPED的15只眼中的4只）sRPED完全消退。
对于其他方法无法治疗的sRPED眼，IVTA似乎是一种治疗选择。
