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中心性浆液性脉络膜视网膜病变低强度光动力疗法治疗 1 年的结果:外核层厚度与视力预后相关。

One-year results of reduced fluence photodynamic therapy for central serous chorioretinopathy: the outer nuclear layer thickness is associated with visual prognosis.

机构信息

Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2013 Aug;251(8):1909-17. doi: 10.1007/s00417-013-2289-4. Epub 2013 Mar 2.

Abstract

PURPOSE

To evaluate the efficacy of reduced-fluence photodynamic therapy (RFPDT) for central serous chorioretinopathy (CSC).

METHODS

This retrospective medical record review of consecutive CSC patients treated with RFPDT (full-dose verteporfin and laser fluence of 25 J/cm(2)) examined 22 eyes of 21 patients (20 males and one female). All patients were followed-up for 1 year. Best-corrected visual acuity (BCVA), complete resolution of subretinal fluid (CR of SRF), central retinal thickness (CRT), the outer nuclear layer (ONL) thickness, and the photoreceptor inner and outer segments (IS/OS) line determined by optical coherence tomography imaging were evaluated at baseline, 1, 3, 6, 9, and 12 months after initial RFPDT.

RESULTS

A single RFPDT session was performed in all cases during a 12-month period. CR of SRF was identified in all patients. BCVA significantly improved between 3 and 12 months (P < 0.05). The CRT significantly decreased between 1 and 12 months. A significantly thicker ONL was observed at 1 month, and 17 eyes (77.2 %) showed recovery of the continuous foveal IS/OS line. ONL thickness was correlated with BCVA at 12 months (P < 0.01). Stepwise analysis indicated that pre-treatment BCVA (P < 0.01) and ONL thickness (P < 0.01) were significant predictive factors for BCVA at 12 months. Neither ocular nor systemic adverse effects were observed during the follow-up period.

CONCLUSION

RFPDT appears to be an effective treatment method for CSC. ONL thickness is an important visual predictive factor of RFPDT for CSC.

摘要

目的

评估低强度光动力疗法(RFPDT)治疗中心性浆液性脉络膜视网膜病变(CSC)的疗效。

方法

本回顾性病历研究纳入了 21 例(20 名男性,1 名女性)共 22 只眼的 CSC 患者,这些患者均接受了 RFPDT(全剂量维替泊芬和 25 J/cm²的激光强度)治疗。所有患者均随访 1 年。在基线、初始 RFPDT 后 1、3、6、9 和 12 个月时,评估最佳矫正视力(BCVA)、视网膜下液完全消退(SRF 完全消退)、中心视网膜厚度(CRT)、外核层(ONL)厚度以及光相干断层扫描成像确定的光感受器内、外节(IS/OS)线。

结果

在 12 个月的时间内,所有患者均接受了单次 RFPDT 治疗。所有患者均出现 SRF 完全消退。BCVA 在 3 至 12 个月之间显著提高(P < 0.05)。CRT 在 1 至 12 个月之间显著降低。1 个月时观察到 ONL 明显增厚,17 只眼(77.2%)的连续黄斑 IS/OS 线恢复。ONL 厚度与 12 个月时的 BCVA 相关(P < 0.01)。逐步分析表明,治疗前 BCVA(P < 0.01)和 ONL 厚度(P < 0.01)是 12 个月时 BCVA 的显著预测因素。在随访期间未观察到眼部或全身不良反应。

结论

RFPDT 似乎是 CSC 的一种有效治疗方法。ONL 厚度是 RFPDT 治疗 CSC 的一个重要视力预测因素。

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