Li Lei, Yuan Fei, Xu Ge-zhi, Wang Wen-ji
Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China.
Zhonghua Yan Ke Za Zhi. 2012 Feb;48(2):106-13.
To evaluate the effect of Spectral HRA + OCT-guided photodynamic therapy with half-dose verteporfin in the treatment of chronic or recurrent central serous chorioretinopathy.
It was a retrospective case series. Twenty eyes of 18 patients with chronic or recurrent central serous chorioretinopathy were included. PDT was applied with half-dose verteporfin (3 mg/m(2)) on the site of active area shown on Spectral HRA + OCT (defined as focal or diffuse retinal pigment epithelial leakage, choroidal hyperpermeability, or pigment epithelial detachment located within the neurosensory detachment), and patients were observed to determine the anatomic and functional outcomes. Statistical analysis was performed using SAS (version 9.2). A P value of 0.05 was considered statistically significant. Comparisons of pre- and post-treatment best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were performed using a paired t test. The relationship between BCVA and CFT post-treatment was analyzed by linear correlation analysis. Comparisons of the BCVA of eyes with and without the integrity of photoreceptor IS-OS and/or external limiting membrane at the last follow-up visit were performed using two sample t test.
The median CSC duration was 4.5 months (ranged 1 month to 2 years). The median follow-up period after PDT was 8 months (ranged 6 to 20 months). The mean BCVA before PDT was 0.35 ± 0.16 (ranged 0.05 to 0.6), at 3 months after PDT was 0.72 ± 0.32 (ranged 0.1 to 1.5) and at the last follow-up visit was 0.78 ± 0.29 (ranged 0.3 to 1.5) (t = 6.444, 6.883, P < 0.05). Fifteen eyes (75.0%) had improved vision, and 5 eyes (25.0%) had stable vision. The mean CFT was reduced from (369.0 ± 120.9) µm before PDT to (193.3 ± 30.6) µm 1 month after PDT, (194.9 ± 28.3) µm 3 month after PDT and (190.6 ± 33.7) µm at the last follow-up visit (t = -6.836, -6.826, -7.316; P < 0.05). At the last follow-up visit BCVA was not correlated with CFT (r = 0.166, P > 0.05), but BCVA of the eyes with the integrity of photoreceptor IS-OS and/or external limiting membrane was better than that of without (t = -3.53, P < 0.05). Subretinal fluid disappeared in all eyes 1 month after PDT and there was no recurrence during the follow-up.
Spectral HRA + OCT-guided photodynamic therapy with half-dose of verteporfin seems effective and safe for the treatment of chronic or recurrent central serous chorioretinopathy.
评估光谱高分辨率血管造影（Spectral HRA）+光学相干断层扫描（OCT）引导下使用半剂量维替泊芬光动力疗法治疗慢性或复发性中心性浆液性脉络膜视网膜病变的效果。
这是一项回顾性病例系列研究。纳入18例慢性或复发性中心性浆液性脉络膜视网膜病变患者的20只眼。在光谱HRA + OCT显示的活跃区域（定义为局灶性或弥漫性视网膜色素上皮渗漏、脉络膜高通透性或位于神经感觉脱离区内的色素上皮脱离）应用半剂量维替泊芬（3 mg/m²）进行光动力疗法（PDT），并观察患者以确定解剖学和功能结局。使用SAS（9.2版）进行统计分析。P值<0.05被认为具有统计学意义。使用配对t检验比较治疗前后的最佳矫正视力（BCVA）和中心凹厚度（CFT）。通过线性相关分析分析治疗后BCVA与CFT之间的关系。使用两样本t检验比较最后一次随访时感光细胞内节-外节（IS-OS）和/或外界膜完整与不完整的眼的BCVA。
中心性浆液性脉络膜视网膜病变的中位病程为4.5个月（范围1个月至2年）。PDT后的中位随访期为8个月（范围6至20个月）。PDT前平均BCVA为0.35±0.16（范围0.05至0.6），PDT后3个月为0.72±0.32（范围0.1至1.5），最后一次随访时为0.78±0.29（范围0.3至1.5）（t = 6.444，6.883，P<0.05）。15只眼（75.0%）视力改善，5只眼（25.0%）视力稳定。平均CFT从PDT前的（369.0±120.9）µm降至PDT后1个月的（193.3±30.6）µm、PDT后3个月的（194.9±28.3）µm和最后一次随访时的（190.6±33.7）µm（t = -6.836，-6.826，-7.316；P<0.05）。最后一次随访时BCVA与CFT无相关性（r = 0.166，P>0.05），但感光细胞IS-OS和/或外界膜完整的眼的BCVA优于不完整的眼（t = -3.53，P<0.05）。PDT后1个月所有眼中的视网膜下液均消失，随访期间无复发。
光谱HRA + OCT引导下使用半剂量维替泊芬光动力疗法治疗慢性或复发性中心性浆液性脉络膜视网膜病变似乎有效且安全。
