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半剂量光动力疗法治疗中心性浆液性脉络膜视网膜病变中的光感受器破坏

Photoreceptor disruption in central serous chorioretinopathy treated by half-dose photodynamic therapy.

作者信息

Ratanasukon Mansing, Thongthong Koblarp, Bhurayanontachai Patama, Jirarattanasopa Pichai

机构信息

Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat yai, Songkhla Province, Thailand.

出版信息

Clin Ophthalmol. 2013;7:87-92. doi: 10.2147/OPTH.S39584. Epub 2013 Jan 10.

Abstract

BACKGROUND

To evaluate photoreceptor disruption in patients with central serous chorioretinopathy (CSC) treated by half-dose photodynamic therapy (PDT).

METHODS

A total of 29 patients with symptomatic CSC were recruited and underwent half-dose verteporfin PDT covering the leakage sites as observed via fundus fluorescein angiography. The primary outcome was the percentage of patients with the presence of photoreceptor disruption, and the secondary outcome was the correlation between photoreceptor disruption and visual results at the 1-year follow-up.

RESULTS

Photoreceptor disruption was identified in 13 eyes (44.8%) 12 months after treatment. Twenty-seven patients experienced best-corrected visual acuity (BCVA) improvement after PDT, while two patients showed stable BCVA. The mean BCVA in patients with photoreceptor disruption at the baseline and every follow-up visit was significantly lower than that of patients without photoreceptor disruption. However, there was no correlation between the presence or absence of photoreceptor disruption and the improvement of visual acuity because the BCVA gain at the last follow-up visit between the two groups was not significant (P = 0.69). No potential ocular complication was encountered in the study.

CONCLUSION

Photoreceptor disruption was found in about 45% of CSC patients treated by PDT, which ultimately resulted in poor visual outcomes. However, a half-dose PDT might not affect or modify the photoreceptor function because it gave the same pattern of visual recovery in patients with and without photoreceptor cell loss.

摘要

背景

评估接受半剂量光动力疗法(PDT)治疗的中心性浆液性脉络膜视网膜病变(CSC)患者的光感受器破坏情况。

方法

共招募29例有症状的CSC患者,接受半剂量维替泊芬PDT治疗,覆盖眼底荧光血管造影观察到的渗漏部位。主要结局是存在光感受器破坏的患者百分比,次要结局是在1年随访时光感受器破坏与视觉结果之间的相关性。

结果

治疗12个月后,在13只眼中(44.8%)发现光感受器破坏。27例患者在PDT后最佳矫正视力(BCVA)提高,2例患者BCVA稳定。基线及每次随访时存在光感受器破坏的患者的平均BCVA显著低于无该情况的患者。然而,光感受器破坏的有无与视力改善之间无相关性,因为两组最后随访时的BCVA增益无显著差异(P = 0.69)。研究中未遇到潜在的眼部并发症。

结论

在接受PDT治疗的CSC患者中,约45%发现光感受器破坏,这最终导致视觉预后不良。然而,半剂量PDT可能不会影响或改变光感受器功能,因为有无光感受器细胞丢失的患者视觉恢复模式相同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7127/3548438/e77d1fef0e69/opth-7-087f1.jpg

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