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半剂量与半光斑光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变。

Half-fluence versus half-dose photodynamic therapy in chronic central serous chorioretinopathy.

机构信息

Clinica Oculistica Università di Genova, Dipartimento di Neuroscienze, Oftalmologia, Genetica e Scienze Materno Infantili, Genova, Italy; Fondazione per la Macula Onlus, Genova, Italy.

Fondazione per la Macula Onlus, Genova, Italy; Clinica Oculistica - Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy.

出版信息

Am J Ophthalmol. 2014 May;157(5):1033-7. doi: 10.1016/j.ajo.2014.01.022. Epub 2014 Jan 30.

Abstract

PURPOSE

To compare the efficacy and safety of half-fluence vs half-dose photodynamic therapy (PDT) in chronic central serous chorioretinopathy (CSC).

DESIGN

Multicenter retrospective comparison study.

METHODS

Retrospective review of 56 patients affected by chronic CSC, including 28 patients (31 eyes) who received half-fluence PDT and 28 patients (29 eyes) who received half-dose PDT. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), and resolution of subretinal fluid on optical coherence tomography at 1 and 12 months were assessed.

RESULTS

The mean logMAR BCVA improved significantly (P < .001), both in the half-fluence group (from 0.187 [± 0.187] to 0.083 [± 0.164]) and in the half-dose group (from 0.126 [± 0.091] to 0.068 [± 0.091]), at 12 months, without significant difference between the 2 groups. At 1 month a complete resolution of subretinal fluid was observed in 19 half-fluence-treated eyes (61.3%) and in 25 half-dose-treated eyes (86.2%) (P = .04). At 12 months, a complete resolution of subretinal fluid was achieved in 26 half-fluence-treated eyes (83.9%) and 29 half-dose-treated eyes (100%) (P = .0529). Nine eyes (29%) in the half-fluence group and 5 eyes (17.2%) in the half-dose group had at least 1 recurrence of subretinal fluid during the follow-up. Overall there were 15 and 5 recurrences in the half-fluence PDT and half-dose PDT groups, respectively (P = .07). In no eye of either groups was atrophy of the retinal pigment epithelium observed in the area of treatment.

CONCLUSION

Half-dose PDT induced a more rapid reabsorption of the fluid, a more lasting effect, and equal safety with respect to half-fluence PDT.

摘要

目的

比较半剂量与半强度光动力疗法(PDT)治疗慢性中心性浆液性脉络膜视网膜病变(CSC)的疗效和安全性。

设计

多中心回顾性比较研究。

方法

回顾性分析 56 例慢性 CSC 患者,其中 28 例(31 眼)接受半强度 PDT 治疗,28 例(29 眼)接受半剂量 PDT 治疗。评估最佳矫正视力(BCVA)、中心视网膜厚度(CFT)和光学相干断层扫描(OCT)上 1 个月和 12 个月时视网膜下液的分辨率。

结果

两组患者的平均 logMAR BCVA 均显著提高(P<0.001),半强度组(从 0.187[±0.187]提高至 0.083[±0.164])和半剂量组(从 0.126[±0.091]提高至 0.068[±0.091]),但两组间无显著差异。1 个月时,半强度治疗组 19 只眼(61.3%)和半剂量治疗组 25 只眼(86.2%)的视网膜下液完全消退(P=0.04)。12 个月时,半强度治疗组 26 只眼(83.9%)和半剂量治疗组 29 只眼(100%)的视网膜下液完全消退(P=0.0529)。半强度治疗组 9 只眼(29%)和半剂量治疗组 5 只眼(17.2%)在随访期间至少有 1 次视网膜下液复发。半强度 PDT 组和半剂量 PDT 组分别有 15 次和 5 次复发(P=0.07)。两组均未观察到治疗区域的视网膜色素上皮萎缩。

结论

半剂量 PDT 可更快地吸收液体,效果更持久,与半强度 PDT 相比安全性相当。

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