Okamoto Masahiro, Matsuura Toyoaki, Ogata Nahoko
Ophthalmic Surg Lasers Imaging Retina. 2015 Jan;46(1):25-32. doi: 10.3928/23258160-20150101-04.
To quantitatively evaluate choroidal thickness (CT) and choroidal blood flow in the subfoveal region after intravitreal bevacizumab injection (IVB) for the treatment of chronic central serous chorioretinopathy (CSC).
Prospective, comparative study of 20 eyes with chronic CSC and and 20 fellow eyes treated with 1.25 mg/0.05 mL IVB. Subfoveal CT and serous retinal detachment height were measured using enhanced depth imaging optical coherence tomography. Subfoveal choroidal blood flow was assessed by the mean blur rate of laser speckle flowgraphy. IOP, blood pressure, and pulse rate, and ocular perfusion pressure were also measured. All measurements were made before and after IVB.
Subfoveal fluid was not present after IVB in the affected eyes. The mean subfoveal CT decreased from 335 µm at baseline to 304 and 291 µm at 1 and 3 months, respectively, after IVB. Average mean blur rate ratio decreased from baseline to 92.9% and 88.0% at 1 and 3 months, respectively. In the fellow eyes, subfoveal CT and choroidal blood flow decreased slightly from baseline. There was a significant correlation between the decrease in subfoveal CT and choroidal blood flow after IVB in affected eyes. IOP, mean arterial pressure, pulse rate, and ocular perfusion pressure did not change significantly after IVB.
IVB significantly reduced subfoveal CT, choroidal blood flow, and subretinal fluid absorption in eyes with chronic CSC. The reduction of subfoveal CT after IVB was likely caused by the reduction of subfoveal choroidal blood flow.
定量评估玻璃体内注射贝伐单抗(IVB)治疗慢性中心性浆液性脉络膜视网膜病变(CSC)后黄斑中心凹下脉络膜厚度(CT)及脉络膜血流情况。
对20例慢性CSC患眼及20例对侧眼进行前瞻性对照研究,患眼接受1.25mg/0.05mL的IVB治疗。采用增强深度成像光学相干断层扫描测量黄斑中心凹下CT及浆液性视网膜脱离高度。通过激光散斑血流图的平均模糊率评估黄斑中心凹下脉络膜血流。同时测量眼压、血压、脉搏率及眼灌注压。所有测量均在IVB治疗前后进行。
患眼IVB治疗后黄斑中心凹下无积液。患眼IVB治疗后,黄斑中心凹下平均CT从基线时的335μm分别降至治疗后1个月的304μm和3个月的291μm。平均平均模糊率比值从基线分别降至治疗后1个月的92.9%和3个月的88.0%。对侧眼黄斑中心凹下CT及脉络膜血流较基线略有下降。患眼IVB治疗后黄斑中心凹下CT下降与脉络膜血流下降之间存在显著相关性。IVB治疗后眼压、平均动脉压、脉搏率及眼灌注压无明显变化。
IVB可显著降低慢性CSC患眼的黄斑中心凹下CT、脉络膜血流及视网膜下液吸收。IVB治疗后黄斑中心凹下CT降低可能是由于黄斑中心凹下脉络膜血流减少所致。