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频域光学相干断层扫描在慢性中心性浆液性脉络膜视网膜病变半剂量维替泊芬光动力治疗前后形态改变的检测。

Detection of morphologic alterations by spectral-domain optical coherence tomography before and after half-dose verteporfin photodynamic therapy in chronic central serous chorioretinopathy.

机构信息

Department of Ophthalmology, School of Medicine, Nihon University, Tokyo, Japan.

出版信息

Retina. 2011 Oct;31(9):1912-20. doi: 10.1097/IAE.0b013e3182252aa8.

Abstract

PURPOSE

To study the morphologic features of serous retinal detachment, the photoreceptor inner and outer segment junction line, retinal pigment epithelium irregularities, pigment epithelial detachment, and the subfoveal choroid before and after treatment of chronic central serous chorioretinopathy, using spectral-domain optical coherence tomography.

METHODS

We studied 17 eyes of 17 consecutive patients (all men) with chronic central serous chorioretinopathy. We performed photodynamic therapy (PDT) with half-dose (3 mg/m2) verteporfin. We studied morphologic features using spectral-domain optical coherence tomography before and at 1, 3, 6, and 12 months after PDT.

RESULTS

Retinal detachment showed reattachment in 16 of the 17 eyes by 3 months after PDT. The inner and outer segment junction line could be visualized in 13 eyes at 6 months after PDT. Retinal pigment epithelium irregularities were confirmed in all 17 eyes before and during the year after PDT. Pigment epithelial detachment initially disappeared but then recurred in 5 eyes after PDT. Subfoveal highly reflective substances first lessened in intensity but then again became prominent in 2 eyes.

CONCLUSION

The authors identified recurrent pigment epithelial detachment and/or retinal detachment during the 1-year period after PDT. Even if retinal detachment initially disappears, retinal pigment epithelium or choroidal morphologic changes can still develop. The effect of half-dose PDT for chronic central serous chorioretinopathy may thus be temporary.

摘要

目的

使用频域光相干断层扫描研究慢性中心性浆液性脉络膜视网膜病变治疗前后的视网膜脱离形态特征、光感受器内外节连接带、视网膜色素上皮层不规则、色素上皮脱离以及黄斑下脉络膜等方面的形态变化。

方法

我们对 17 例(均为男性)连续的慢性中心性浆液性脉络膜视网膜病变患者的 17 只眼进行了研究。我们采用半剂量(3mg/m2)维替泊芬进行光动力疗法(PDT)。我们在 PDT 治疗前以及治疗后 1、3、6 和 12 个月,使用频域光相干断层扫描来研究形态特征。

结果

在 PDT 治疗后 3 个月,17 只眼中有 16 只眼的视网膜脱离得到了复位。在 PDT 治疗后 6 个月,有 13 只眼可以观察到内外节连接带。在 PDT 治疗前和治疗后的 1 年内,所有 17 只眼都可以确认存在视网膜色素上皮层不规则。初始时色素上皮脱离消失,但在 PDT 治疗后 5 只眼又复发。黄斑下高反射物质的强度起初减弱,但在 2 只眼中又再次变得明显。

结论

作者在 PDT 治疗后 1 年内发现了复发性色素上皮脱离和/或视网膜脱离。即使视网膜脱离最初消失,视网膜色素上皮或脉络膜的形态变化仍可能会发生。因此,半剂量 PDT 治疗慢性中心性浆液性脉络膜视网膜病变的效果可能是暂时的。

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