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光学相干断层扫描血管造影评估半剂量光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变后早期脉络膜毛细血管的变化:初步结果。

Early choriocapillaris changes after half-fluence photodynamic therapy in chronic central serous chorioretinopathy evaluated by optical coherence tomography angiography: Preliminary results.

机构信息

University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.

University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.

出版信息

Photodiagnosis Photodyn Ther. 2018 Mar;21:375-378. doi: 10.1016/j.pdpdt.2018.01.015. Epub 2018 Feb 2.

Abstract

BACKGROUND

The purpose of this study is to examine the choridal perfusion in patients with chronic central serous chorioretinopathy (CSC) after half-fluence photodynamic therapy (PDT) in the early post-treatment period.

METHODS

This retrospective study included patients with chronic CSC. Indocyanine green angiography (ICGA) guided half-fluence PDT was applied to the all eyes. Best corrected visual acuity (BCVA) was assessed by Snellen chart and central retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) was measured by spectral domain optical coherence tomography (SD-OCT) before PDT and at 3 and 30 days following the therapy. Optical coherence tomography angiography (OCTA) was performed to evaluate choriocapillaris perfusion in all patients before PDT and 3 and 30 days of therapy.

RESULTS

Of the patients participating in this study, the mean age was 49.8 ± 14.1 years. BCVA remained stable in all eyes during follow-up period. CRT was 360 ± 148 μm at baseline, 327 ± 133 μm at day 3 and 203 ± 40 μm at day 30 after treatment. Subretinal fluid totally resolved at day 30 in all eyes. The mean SFCT was 493 ± 67 μm at baseline, 498 ± 71 μm at day 3 and 450 ± 63 μm at day 30. At day 3, OCTA revealed markedly decreased choriocapillaris flow limited to the site of PDT spot. The choriocapillaris perfusion appeared to be normal in all eyes in OCTA images at day 30.

CONCLUSIONS

OCTA is a noninvasive imaging tool for detecting choroidal vascular changes after PDT in CSC. In this preliminary study of a limited number of CSC patients, choroiocapillaris perfusion seemed to decreased in very early period following half-fluence PDT and then returned to normal until 30 days of therapy.

摘要

背景

本研究旨在探讨慢性中心性浆液性脉络膜视网膜病变(CSC)患者在半剂量光动力疗法(PDT)治疗后的早期治疗后脉络膜灌注情况。

方法

本回顾性研究纳入了慢性 CSC 患者。所有患者均接受吲哚青绿血管造影(ICGA)引导的半剂量 PDT。在 PDT 前、治疗后 3 天和 30 天,通过视力表评估最佳矫正视力(BCVA),通过光谱域光相干断层扫描(SD-OCT)测量中心视网膜厚度(CRT)和中心凹下脉络膜厚度(SFCT)。所有患者在 PDT 前和治疗后 3 天和 30 天均行光学相干断层扫描血管造影(OCTA)评估脉络膜毛细血管灌注情况。

结果

本研究中,患者的平均年龄为 49.8±14.1 岁。所有患者在随访期间的 BCVA 均保持稳定。CRT 在基线时为 360±148μm,治疗后第 3 天为 327±133μm,第 30 天为 203±40μm。所有患者的视网膜下液在第 30 天完全吸收。SFCT 的平均基线值为 493±67μm,第 3 天为 498±71μm,第 30 天为 450±63μm。第 3 天,OCTA 显示脉络膜毛细血管血流明显减少,局限于 PDT 光斑部位。在第 30 天的 OCTA 图像中,所有患者的脉络膜毛细血管灌注似乎均恢复正常。

结论

OCTA 是一种用于检测 CSC 患者 PDT 后脉络膜血管变化的非侵入性成像工具。在这项针对有限数量 CSC 患者的初步研究中,半剂量 PDT 治疗后早期脉络膜毛细血管灌注似乎减少,然后在治疗后 30 天恢复正常。

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