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应用扫频源光学相干断层扫描评估光动力疗法治疗中心性浆液性脉络膜视网膜病变后的脉络膜地形图改变。

Assessment of choroidal topographic changes by swept source optical coherence tomography after photodynamic therapy for central serous chorioretinopathy.

机构信息

Department of Ophthalmology, University of Paris Est Creteil, Centre Hospitalier Intercommunal de Creteil, Creteil, France; Transparence Eye Clinic, Tours, France.

Department of Ophthalmology, University of Paris Est Creteil, Centre Hospitalier Intercommunal de Creteil, Creteil, France.

出版信息

Am J Ophthalmol. 2014 Apr;157(4):852-60. doi: 10.1016/j.ajo.2013.12.029. Epub 2014 Jan 9.

Abstract

PURPOSE

To investigate the relationship between choroidal thickness and angiographic abnormalities in central serous chorioretinopathy (CSC) eyes by swept-source optical coherence tomography (swept-OCT), before and after half-fluence photodynamic therapy (PDT).

DESIGN

Prospective interventional case series.

METHODS

Consecutive patients presenting with treatment-naive active CSC underwent a complete ophthalmologic examination, including swept-OCT at study entry and at 7 days and 30 days after treatment with half-fluence PDT. The main outcome measures were changes in choroidal maps after PDT (mean ± SD) and the relationship between choroidal thickness and angiographic abnormalities.

RESULTS

Of 12 patients (2 females, 10 males; mean age, 55.6 ± 14.0 years), 12 eyes were included. At study entry, mean choroidal thickness measured in the center of the fovea was significantly thicker in the study eyes as compared to the fellow eyes (420.7 ± 107.5 μm vs 349.2 ± 109.7 μm, respectively; P = 0.016). Mean choroidal thickness in the center of the fovea significantly decreased in the study eyes at both 7 days (380.2 ± 113 μm; P = 0.005) and 30 days after PDT (362.3 ± 111 μm; P = 0.002). A similar significant choroidal thinning was recorded in each early treatment of diabetic retinopathy study (ETDRS) applied to 3D swept-OCT maps. At each time point, mean choroidal thickness was significantly thicker in sectors with than in sectors without angiographic abnormalities (421 ± 102.4 μm vs 397.6 ± 96.5 μm, P = 0.002 at study entry; 381.2 ± 106.6 μm vs 364 ± 101.2 μm, P = 0.01 at day 7; 366.3 ± 103.2 μm vs 347.2 ± 99.6 μm at day 30).

CONCLUSIONS

Using swept-OCT, we demonstrated that in active CSC, choroidal thickness is increased to a greater extent in areas characterized by angiographic abnormalities. This increased choroidal thickness may persist even after PDT.

摘要

目的

通过扫频源光学相干断层扫描(扫频 OCT)研究未经光动力疗法(PDT)和半剂量 PDT 治疗前后中心性浆液性脉络膜视网膜病变(CSC)眼脉络膜厚度与血管造影异常的关系。

设计

前瞻性干预性病例系列研究。

方法

对未经 PDT 治疗的活动性 CSC 患者进行完整的眼科检查,包括治疗前、PDT 治疗后 7 天和 30 天的扫频 OCT。主要观察指标是 PDT 后脉络膜图的变化(平均值±标准差)以及脉络膜厚度与血管造影异常的关系。

结果

12 例患者(2 例女性,10 例男性;平均年龄 55.6±14.0 岁)12 只眼纳入研究。在研究开始时,黄斑中心凹的脉络膜厚度在研究眼中明显比在对侧眼中厚(分别为 420.7±107.5μm和 349.2±109.7μm,P=0.016)。黄斑中心凹的脉络膜厚度在研究眼中分别于 7 天(380.2±113μm;P=0.005)和 PDT 后 30 天(362.3±111μm;P=0.002)显著下降。在每个早期糖尿病性视网膜病变治疗研究(ETDRS)的应用中,3D 扫频 OCT 图谱均记录到类似的脉络膜明显变薄。在每个时间点,有血管造影异常的区域的脉络膜厚度均明显高于无血管造影异常的区域(分别为 421±102.4μm 和 397.6±96.5μm,P=0.002;381.2±106.6μm 和 364±101.2μm,P=0.01;366.3±103.2μm 和 347.2±99.6μm,P=0.03)。

结论

应用扫频 OCT,我们发现活动性 CSC 中,血管造影异常区域的脉络膜厚度增加更为明显。即使在 PDT 后,这种脉络膜厚度的增加仍可能持续存在。

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