Höhn F, Kretz F T A, Beger I, Koch F, Auffarth G U, Singh P, Deuchler S, Koss M J
Klinik für Augenheilkunde, HELIOS Klinikum Pforzheim.
Augenklinik, Universitätsklinikum Heidelberg.
Klin Monbl Augenheilkd. 2016 Jul;233(7):860-3. doi: 10.1055/s-0041-106194. Epub 2015 Nov 26.
To estimate the efficacy and safety profile of half-dose photodynamic therapy (hdPDT) for treating central serous chorioretinopathy (CSC).
An interventional, retrospective case series of patients with CSC (symptoms ≧ 3 months) receiving half-dose PDT (3 mg/m2 verteporfin). The ophthalmic examination at baseline and at 8 and 16 weeks after treatment included slit-lamp biomicroscopy, indirect ophthalmoscopy, measurement of intraocular pressure (IOP), ETDRS best-corrected visual acuity (BCVA), Amsler grid screening and contrast visual acuity (CVA). Fluorescein angiography (FA), autofluorescence (FAF) and optical coherence tomography (OCT) were measured at each visit. Central macular thickness (CMT) was measured automatically.
12 eyes of 12 patients (10 male and 2 female patients; mean age 46.6 ± 7.91 years) were included in this study. Anatomical resolution was obtained in 10 eyes (83.4 %) at week 16, but 2 eyes (16.6 %) exhibited persistent SRD throughout the follow-up period. Baseline CMT decreased from initially 330.1 µm ± 131.3 to 205.6 µm ± 97.6 (p = 0.034) at week 8 and to 220.3 µm ± 120.1 (p = 0.05) at week 16. Visual acuity (number of total letters read) significantly improved from initially 82.8 ± 11.5 to 86.8 ± 13.9 at week 8 and 91.3 ± 13.8 at week 16 (p = 0.012). Contrast visual acuity (calculated decimal visual acuity) significantly improved from initially 0.14 ± 0.09 to 0.38 ± 0.28 (p = 0.002) at week 16. After therapy, no significant changes in RPE could be detected with FAF and no ocular adverse events were observed.
PDT with half-dose verteporfin resulted in reduced leakage in FA, enhanced visual acuity and resolution of subretinal fluid in OCT in patients with CSC, with no detected side effects of treatment.
评估半剂量光动力疗法（hdPDT）治疗中心性浆液性脉络膜视网膜病变（CSC）的疗效和安全性。
一项对CSC患者（症状≥3个月）进行的干预性回顾性病例系列研究，这些患者接受半剂量PDT（3mg/m²维替泊芬）治疗。治疗前、治疗后8周和16周的眼科检查包括裂隙灯生物显微镜检查、间接检眼镜检查、眼压（IOP）测量、ETDRS最佳矫正视力（BCVA）、Amsler方格表筛查和对比视力（CVA）。每次就诊时均测量荧光素血管造影（FA）、自发荧光（FAF）和光学相干断层扫描（OCT）。自动测量中心黄斑厚度（CMT）。
本研究纳入了12例患者的12只眼（10例男性和2例女性患者；平均年龄46.6±7.91岁）。16周时10只眼（83.4%）获得了解剖学上的缓解，但2只眼（16.6%）在整个随访期间均表现为持续性视网膜下液（SRD）。基线CMT从最初的330.1μm±131.3降至8周时的205.6μm±97.6（p=0.034），并在16周时降至220.3μm±120.1（p=0.05）。视力（读出的字母总数）从最初的82.8±11.5显著提高至8周时的86.8±13.9以及16周时的91.3±13.8（p=0.012）。对比视力（计算得出的小数视力）从最初的0.14±0.09显著提高至16周时的0.38±0.28（p=0.002）。治疗后，FAF未检测到视网膜色素上皮（RPE）有明显变化，且未观察到眼部不良事件。
对于CSC患者，半剂量维替泊芬的PDT可使FA中的渗漏减少，视力提高，OCT显示视网膜下液消退，且未检测到治疗的副作用。
