Sheptulin Vladimir, Purtskhvanidze Konstantine, Roider Johann
Department of Ophthalmology, University of Kiel, UKSH Campus Kiel, Arnold Heller str. 3, 24105, Kiel, Germany.
Graefes Arch Clin Exp Ophthalmol. 2018 Nov;256(11):2027-2034. doi: 10.1007/s00417-018-4086-6. Epub 2018 Aug 10.
Different modes of photodynamic therapy (PDT) were described for treatment of central serous chorioretinopathy (CSC). The purpose of the current study was to evaluate the outcome of half-time PDT in chronic CSC.
A retrospective case series study, including 114 eyes of 103 patients with chronic CSC, treated with reduced-fluence PDT. PDT was applied with full-dose verteporfin (6 mg/m) and half-time fluence (43 s). The main outcome measures included timing of complete subretinal fluid (SRF) resolution, recurrences, pre- and post-treatment best-corrected visual acuities (BCVA). Anatomical and functional effects were compared in subgroup analysis on the basis of CSC treatment efficacy. Subsequent analysis was performed to compare eyes with and without recurrences and CSC eyes treated by single and multiple PDT sessions.
A total of 114 eyes of 103 patients (81 male; 22 female) were analyzed. The median age was 49 (28-70). The median CSC pretreatment duration was 12 months (3-393). The median follow-up period after PDT was 8 months (6-111). By the sixth-month period PDT was effective in 80% (91 eyes), with a subsequent enhancement up to 87% (99 eyes) at 12th month and not effective in 13% (15 eyes). SRF resolution was achieved after 8 weeks (2-44) with a significant improvement of median LogMAR BCVA from 0.22 (- 0.2-1.3) before PDT to 0.1 (- 0.2-1.0) at last visit after PDT (p < 0.0001).
Half-time PDT has proven to be an effective and safe treatment option for patients with chronic CSC with a significant BCVA improvement during the follow-up after the therapy.
描述了不同模式的光动力疗法(PDT)用于治疗中心性浆液性脉络膜视网膜病变(CSC)。本研究的目的是评估半剂量PDT治疗慢性CSC的效果。
一项回顾性病例系列研究,纳入103例慢性CSC患者的114只眼,采用低能量PDT治疗。使用全剂量维替泊芬(6mg/m²)和半剂量能量(43秒)进行PDT。主要观察指标包括视网膜下液(SRF)完全吸收的时间、复发情况、治疗前后的最佳矫正视力(BCVA)。在基于CSC治疗效果的亚组分析中比较解剖学和功能学效应。进行后续分析以比较有复发和无复发的眼,以及接受单次和多次PDT治疗的CSC眼。
共分析了103例患者(81例男性;22例女性)的114只眼。中位年龄为49岁(28 - 70岁)。CSC治疗前的中位病程为12个月(3 - 393个月)。PDT后的中位随访期为8个月(6 - 111个月)。到第6个月时,PDT对80%(91只眼)有效,到第12个月时有效率提高到87%(99只眼),13%(15只眼)无效。8周(2 - 44周)后SRF吸收,中位LogMAR BCVA从PDT前的0.22(-0.2 - 1.3)显著改善至PDT后末次随访时的0.1(-0.2 - 1.0)(p < 0.0001)。
半剂量PDT已被证明是慢性CSC患者的一种有效且安全的治疗选择,治疗后随访期间BCVA有显著改善。