Kim Yong-Kyu, Ryoo Na-Kyung, Woo Se Joon, Park Kyu Hyung
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, #300, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Graefes Arch Clin Exp Ophthalmol. 2015 Dec;253(12):2063-73. doi: 10.1007/s00417-014-2926-6. Epub 2015 Jan 24.
To compare visual and anatomical outcomes of half-fluence (HF) and half-dose (HD) photodynamic therapy (PDT) in chronic central serous chorioretinopathy (CSC). Particular focus was given to photoreceptor recovery rate following treatment.
Retrospective review of 52 chronic CSC patients who underwent HF- or HD-PDT (26 patients per group). Best-corrected visual acuity and spectral-domain optical coherence tomography findings were compared between groups.
Average follow-up for HF- and HD-PDT was 20.7 ± 7.2 and 22.3 ± 6.1 months respectively. Both groups had significant visual acuity improvements, as well as central foveal and subfoveal choroidal thickness reductions. Measured parameters were not significantly different between groups at any time point examined. Complete photoreceptor recovery, defined as a continuous ellipsoid zone with a discernible interdigitation zone, was observed at 12 months in 19 (73 %) and 14 patients (54 %) in the HF- and HD-PDT groups respectively (p = 0.150). Overall photoreceptor recovery rate was not different between groups (p = 0.301, log-rank test). Delayed (>12 months) photoreceptor recovery was significantly associated with baseline external limiting membrane disruption (OR: 21.7, 95 % CI: 1.7-285.4, p = 0.019), disease duration (years, OR: 1.9, 95 % CI: 1.2-3.0, p = 0.005), and fovea-to-PDT spot center distance (100 μm unit, OR: 0.74, 95 % CI 0.56-0.97, p = 0.027). However, delayed photoreceptor recovery was not significantly associated with PDT modality.
Both HF- and HD-PDT are effective in treating chronic CSC. No significant differences in visual or anatomical outcomes were observed.
比较半剂量（HF）和半辐照度（HD）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）的视觉和解剖学结果。特别关注治疗后的光感受器恢复率。
回顾性分析52例接受HF-PDT或HD-PDT治疗的慢性CSC患者（每组26例）。比较两组的最佳矫正视力和光谱域光学相干断层扫描结果。
HF-PDT和HD-PDT的平均随访时间分别为20.7±7.2个月和22.3±6.1个月。两组的视力均有显著改善，中央凹和黄斑下脉络膜厚度均降低。在任何检查时间点，两组间测量参数均无显著差异。HF-PDT组和HD-PDT组分别有19例（73%）和14例（54%）患者在12个月时观察到光感受器完全恢复，定义为连续的椭圆体带和可辨别的指状交叉带（p=0.150）。两组的总体光感受器恢复率无差异（p=0.301，对数秩检验）。延迟（>12个月）光感受器恢复与基线外限制膜破坏显著相关（OR：21.7，95%CI：1.7-285.4，p=0.019）、疾病持续时间（年，OR：1.9，95%CI：1.2-3.0，p=0.005）以及中央凹至PDT光斑中心距离（100μm单位，OR：0.74，95%CI 0.56-0.97，p=0.027）。然而，延迟光感受器恢复与PDT方式无显著相关。
HF-PDT和HD-PDT治疗慢性CSC均有效。在视觉或解剖学结果方面未观察到显著差异。
