Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain.
Acta Ophthalmol. 2010 May;88(3):371-6. doi: 10.1111/j.1755-3768.2008.01408.x. Epub 2009 Nov 27.
This study aimed to evaluate the efficacy of photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC).
We describe a non-randomized, multicentre, interventional case series. A total of 82 eyes of 72 patients with chronic CSC were treated by conventional PDT. LogMAR best corrected visual acuity (BCVA) (ETDRS charts) and central foveal thickness (CFT) measured by optical coherence tomography before and after PDT, number of PDT treatments and complications were used as outcome indicators.
Mean follow-up was 12 +/- 10 months and mean age was 46 +/- 10 years. Mean logMAR BCVA changed from 0.53 (standard deviation [SD] 0.43) before PDT to 0.38 (SD 0.41) at 3 months and 0.48 (SD 0.50) at 6 months (p < 0.0001 and p = 0.007, respectively, Student's t-test for paired data). Mean BCVA at the end of follow-up was 0.37 (SD 0.45; p < 0.0001 from baseline). Macular detachment was resolved and subretinal fluid (SRF) disappeared in all cases. Central foveal thickness decreased from 325 microm (SD 95), to 229 microm (SD 70) at 1 month after PDT, 206 microm (SD 68) at 3 months, and 202 microm (SD 76) at 6 months (all p < 0.0001, Student's t-test for paired data). No cases developed severe visual loss or complications derived from PDT. Reactive retinal pigment epithelium hypertrophy appeared in nine cases after PDT.
Photodynamic therapy with verteporfin may be useful in chronic CSC for improving BCVA and reducing SRF and CFT. Randomized studies with longer follow-up are needed to assess the real role of this treatment in chronic CSC.
本研究旨在评估光动力疗法(PDT)治疗慢性中心性浆液性脉络膜视网膜病变(CSC)的疗效。
我们描述了一项非随机、多中心、干预性病例系列研究。82 只眼(72 例患者)患有慢性 CSC,接受了常规 PDT 治疗。PDT 前后使用最佳矫正视力对数视力表(ETDRS 图表)和光学相干断层扫描测量的中心黄斑厚度(CFT)、PDT 治疗次数和并发症作为结局指标。
平均随访时间为 12±10 个月,平均年龄为 46±10 岁。平均 logMAR 最佳矫正视力(BCVA)在 PDT 前为 0.53(标准差[SD] 0.43),在 3 个月时为 0.38(SD 0.41),在 6 个月时为 0.48(SD 0.50)(p<0.0001 和 p=0.007,分别为配对数据 Student's t 检验)。在随访结束时,平均 BCVA 为 0.37(SD 0.45;与基线相比 p<0.0001)。所有病例的黄斑脱离均已缓解,视网膜下液(SRF)消失。中央黄斑厚度在 PDT 后 1 个月从 325μm(SD 95)下降至 229μm(SD 70),3 个月时下降至 206μm(SD 68),6 个月时下降至 202μm(SD 76)(均 p<0.0001,配对数据 Student's t 检验)。无病例出现严重视力丧失或 PDT 相关并发症。PDT 后有 9 例出现反应性视网膜色素上皮肥厚。
维替泊芬光动力疗法可能对改善慢性 CSC 的 BCVA 及减少 SRF 和 CFT 有效。需要进行具有更长随访时间的随机研究,以评估该治疗方法在慢性 CSC 中的实际作用。