Rouvas Alexander, Nikita Eleni, Chatziralli Irini, Ladas Ioannis, Androu Aggeliki, Theodossiadis Panagiotis
2nd Department of Ophthalmology, Attikon University Hospital, University of Athens, Athens - Greece.
Eur J Ophthalmol. 2015 May-Jun;25(3):229-34. doi: 10.5301/ejo.5000541. Epub 2014 Nov 24.
To evaluate the long-term efficacy and safety of standard-fluence photodynamic therapy (PDT) with verteporfin using the minimum PDT spot size in patients with diffuse retinal pigment epitheliopathy (DRPE).
This is a retrospective study of 67 DRPE cases treated with PDT using a standardized minimum spot size of 850 μm. Indocyanine green angiography (ICGA) was used to guide and determine the outcome of PDT treatment. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), recurrences, and adverse events were recorded and analyzed.
The mean follow-up period of the study was 35.8 ± 16.6 months. There was a statistically significant difference in BCVA between baseline and the end of the follow-up (p<0.001). The BCVA improved in 41 eyes (61.2%), remained stable in 20 eyes (29.9%), and deteriorated in 6 eyes (9%). Accordingly, there was a statistically significant difference in CRT between the baseline and the last follow-up visit (p<0.001). The recurrence rate was 13.4% and only one eye presented a recurrence at the same site as the laser treatment. No adverse events were noted.
Application of ICGA-guided standard PDT, with a laser spot size of minimum diameter, on the site of active leakage seems to be effective and safe in a long-term follow-up period, presenting improvement in BCVA, decrease in CRT, and low rate of recurrence.
评估使用维替泊芬进行标准能量光动力疗法（PDT）并采用最小PDT光斑尺寸治疗弥漫性视网膜色素上皮病变（DRPE）患者的长期疗效和安全性。
这是一项对67例接受PDT治疗的DRPE病例的回顾性研究，采用标准化的最小光斑尺寸850μm。吲哚菁绿血管造影（ICGA）用于指导和确定PDT治疗的结果。记录并分析最佳矫正视力（BCVA）、中心视网膜厚度（CRT）、复发情况和不良事件。
研究的平均随访期为35.8±16.6个月。基线时和随访结束时的BCVA存在统计学显著差异（p<0.001）。41只眼（61.2%）的BCVA有所改善，20只眼（29.9%）保持稳定，6只眼（9%）恶化。因此，基线时和最后一次随访时的CRT存在统计学显著差异（p<0.001）。复发率为13.4%，只有一只眼在与激光治疗相同的部位复发。未观察到不良事件。
在长期随访中，在活性渗漏部位应用ICGA引导的标准PDT，采用最小直径的激光光斑尺寸似乎是有效且安全的，表现为BCVA改善、CRT降低和复发率低。
