Shimizu Kimiko, Hashimoto Yohei, Azuma Keiko, Nomura Yoko, Obata Ryo, Takahashi Hidenori, Yanagi Yasuo
Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, University of Tokyo, Tokyo.
Department of Ophthalmology, Jichi Medical University, Tochigi, Japan.
Clin Ophthalmol. 2017 Aug 16;11:1505-1512. doi: 10.2147/OPTH.S139288. eCollection 2017.
To evaluate the morphological changes in retinal microstructures following modified photodynamic therapy (PDT) for chronic central serous chorioretinopathy.
Retrospective study of 21 consecutive eyes (age, 59±8.0 years [mean ± SD]) of 21 patients with chronic central serous chorioretinopathy. Inner foveal thickness (the distance between the internal limiting membrane and external limiting membrane), photoreceptor outer segment (PROS) length at the point without serous retinal detachment and choroidal thickness were assessed with enhanced depth imaging optical coherence tomography before treatment and at 1, 3 and 6 months after modified PDT.
Six eyes had half-dose and 15 eyes had half-fluence PDT. PROS length within the irradiated area was significantly decreased by 3.9% at 1 month compared with that before modified PDT (43.5±5.72 and 40.5±7.53, =0.020 [paired -test]) and returned to baseline length at 3 and 6 months (43.0±5.42 and 43.5±4.33 μm [mean ± SD]; =0.53 and 1.00 [paired -test]). PROS length of the nonirradiated area at 1, 3 and 6 months after modified PDT did not significantly differ from that before PDT (41.8±6.35, 41.4±5.33, 41.9±4.67 and 42.3±4.26 μm [mean ± SD]; =0.66, 0.90 and 0.60, respectively [paired -test]). There was no significant change in inner foveal thickness during the observation period. At all time points, choroidal thickness was significantly thinner than it was before PDT (<0.001, paired -test).
Modified PDT may cause mild temporary microstructural changes.
评估改良光动力疗法（PDT）治疗慢性中心性浆液性脉络膜视网膜病变后视网膜微观结构的形态学变化。
对21例慢性中心性浆液性脉络膜视网膜病变患者的21只连续眼（年龄，59±8.0岁[均值±标准差]）进行回顾性研究。在治疗前以及改良PDT治疗后1、3和6个月，使用增强深度成像光学相干断层扫描评估中心凹内层厚度（内界膜与外界膜之间的距离）、无浆液性视网膜脱离处的光感受器外段（PROS）长度以及脉络膜厚度。
6只眼接受了半剂量PDT，15只眼接受了半光通量PDT。与改良PDT治疗前相比，照射区域内的PROS长度在1个月时显著降低了3.9%（43.5±5.72和40.5±7.53，P = 0.020[配对t检验]），并在3个月和6个月时恢复至基线长度（43.0±5.42和43.5±4.33μm[均值±标准差]；P = 0.53和1.00[配对t检验]）。改良PDT治疗后1、3和6个月时，未照射区域的PROS长度与PDT治疗前相比无显著差异（41.8±6.35、41.4±5.33、41.9±4.67和42.3±4.26μm[均值±标准差]；P分别为0.66、0.90和0.60[配对t检验]）。观察期内中心凹内层厚度无显著变化。在所有时间点，脉络膜厚度均显著薄于PDT治疗前（P<0.001；配对t检验）。
改良PDT可能会引起轻度的暂时性微观结构变化。
