Noh Sung Rae, Kang Min Seok, Kim Kiyoung, Kim Eung Suk, Yu Seung Young
Department of Ophthalmology, KyungHee University Hospital, KyungHee University School of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2019 Dec;33(6):506-513. doi: 10.3341/kjo.2019.0065.
To evaluate the efficacy of focal verteporfin photodynamic therapy (PDT) in patients diagnosed with chronic central serous chorioretinopathy (CSC).
This study enrolled 52 eyes of 52 patients with chronic CSC who had received verteporfin PDT. The laser spot size of 26 eyes covering only the localized hyperfluorescent area in indocyanine green angiography was classified as focal PDT. The PDT spot size of the other 26 eyes covered the total area of retinal pigment epithelial detachment including the leaking point and was defined as conventional PDT. The central subfield thickness and subfoveal choroidal thickness were measured using Heidelberg Spectralis optical coherence tomography before PDT and at months 1, 3, 6, and 12 after PDT.
The mean spot size of the PDT was 1,995 μm in the focal group and 2,995 μm in the conventional group. Central subfield thickness steadily decreased in both groups. The mean baseline subfoveal choroidal thickness for the two groups was 334.95 and 348.35 μm, respectively, with no significant difference ( = 0.602). Subfoveal choroidal thickness decreased significantly to 304.20 μm at 1 month, 284.85 μm at 3 months, 271.60 μm at 6 months, and 265.95 μm at 12 months in the focal group ( < 0.001, < 0.001, < 0.001, and < 0.001, respectively, compared with baseline). In the conventional group, subfoveal choroidal thickness decreased significantly to 318.75, 300, 284, and 272 μm at 1, 3, 6, and 12 months, respectively ( < 0.001, < 0.001, < 0.001 and < 0.001 compared with baseline). There were no significant differences between the two groups in subfoveal choroidal thickness based on PDT spot size at 1, 3, 6, and 12 months ( = 0.633, = 0.625, = 0.676, and =0.755, respectively).
Focal verteporfin PDT for CSC significantly decreased the subretinal fluid and sufoveal choroidal thickness to the same extent as conventional PDT.
评估聚焦型维替泊芬光动力疗法（PDT）对诊断为慢性中心性浆液性脉络膜视网膜病变（CSC）患者的疗效。
本研究纳入了52例接受维替泊芬PDT治疗的慢性CSC患者的52只眼。26只眼的激光光斑大小仅覆盖吲哚菁绿血管造影中的局限性高荧光区，被分类为聚焦型PDT。另外26只眼的PDT光斑大小覆盖了包括渗漏点在内的视网膜色素上皮脱离的总面积，被定义为传统型PDT。在PDT治疗前以及PDT治疗后1、3、6和12个月，使用海德堡Spectralis光学相干断层扫描测量中心子野厚度和黄斑中心凹下脉络膜厚度。
聚焦型组PDT的平均光斑大小为1995μm，传统型组为2995μm。两组的中心子野厚度均稳步下降。两组的平均基线黄斑中心凹下脉络膜厚度分别为334.95μm和348.35μm，无显著差异（P = 0.602）。聚焦型组黄斑中心凹下脉络膜厚度在1个月时显著降至304.20μm，3个月时降至284.85μm，6个月时降至271.60μm，12个月时降至265.95μm（与基线相比，P均<0.001）。在传统型组中，黄斑中心凹下脉络膜厚度在1、3、6和12个月时分别显著降至318.75μm、300μm、284μm和272μm（与基线相比，P均<0.001）。在1、3、6和12个月时，基于PDT光斑大小的两组黄斑中心凹下脉络膜厚度无显著差异（P分别为0.633、0.625、0.676和0.755）。
用于CSC的聚焦型维替泊芬PDT与传统型PDT一样，能显著降低视网膜下液和黄斑中心凹下脉络膜厚度。
