Haga Fuminori, Maruko Ruka, Sato Chiaki, Kataoka Keiko, Ito Yasuki, Terasaki Hiroko
Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Japan.
PLoS One. 2017 Jul 24;12(7):e0181479. doi: 10.1371/journal.pone.0181479. eCollection 2017.
To evaluate the long-term efficacy and factors involved in the recurrence and persistence of subretinal fluid (SRF) after half-dose photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC).
In this retrospective observational case series, 79 eyes (73 patients) with chronic CSC were treated with half-dose PDT and followed up for at least 3 years. They were divided into successful (64 eyes) and unsuccessful (15 eyes) groups based on SRF absorption and disease recurrence after one PDT session. Age, best-corrected visual acuity (BCVA), central foveal thickness, neuroretinal thickness, height of SRF, subfoveal choroidal thickness, window defect area detected by fluorescein angiography, and PDT spot area were compared between the groups. Factors associated with PDT success and BCVA at 3 years were investigated.
LogMAR BCVA improved from 0.21±0.24 to 0.08±0.16 (P<0.001) at 3 years after PDT. Compared with the unsuccessful group, the successful group had a significantly younger mean age (50.5±9.7 vs. 56.5±9.1 years, P = 0.032) and better baseline BCVA (0.18±0.23 vs. 0.32±0.25, P = 0.034). Other parameters were not significantly different. Multivariate analyses showed that unsuccessful PDT was significantly associated with lower baseline BCVA (P = 0.026) and older age (P = 0.029) and that BCVA at 3 years after PDT was positively associated with baseline BCVA (P<0.001).
Half-dose PDT has a long-term efficacy in chronic CSC. Relatively early PDT may improve anatomic and functional outcomes of chronic CSC.
评估半剂量光动力疗法(PDT)治疗慢性中心性浆液性脉络膜视网膜病变(CSC)后视网膜下液(SRF)复发和持续存在的长期疗效及相关因素。
在这个回顾性观察性病例系列中,79只眼(73例患者)的慢性CSC接受了半剂量PDT治疗,并随访至少3年。根据一次PDT治疗后SRF吸收情况和疾病复发情况,将其分为成功组(64只眼)和失败组(15只眼)。比较两组之间的年龄、最佳矫正视力(BCVA)、中心凹厚度、神经视网膜厚度、SRF高度、黄斑下脉络膜厚度、荧光素血管造影检测到的窗样缺损面积以及PDT光斑面积。研究与PDT治疗成功及3年后BCVA相关的因素。
PDT治疗3年后,LogMAR BCVA从0.21±0.24改善至0.08±0.16(P<0.001)。与失败组相比,成功组的平均年龄显著更年轻(50.5±9.7岁 vs. 56.5±9.1岁,P = 0.032),基线BCVA更好(0.18±0.23 vs. 0.32±0.25,P = 0.034)。其他参数无显著差异。多因素分析显示,PDT治疗失败与较低的基线BCVA(P = 0.026)和较高的年龄(P = 0.029)显著相关,且PDT治疗3年后的BCVA与基线BCVA呈正相关(P<0.001)。
半剂量PDT对慢性CSC具有长期疗效。相对早期进行PDT可能改善慢性CSC的解剖和功能预后。