Cennamo Gilda, Montorio Daniela, Comune Chiara, Clemente Lidia, Iovino Claudio, Carandente Raffaella, Tranfa Fausto
Department of Public Health, University of Naples Federico II, Naples, Italy.
Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy.
Photodiagnosis Photodyn Ther. 2020 Jun;30:101742. doi: 10.1016/j.pdpdt.2020.101742. Epub 2020 Mar 18.
To perform a quantitative analysis of retinal and choriocapillaris vessel density (VD) in patients with central serous chorioretinopathy (CSC) after low-fluence verteporfin photodynamic therapy (vPDT), using Optical Coherence Tomography Angiography (OCTA).
A total of 28 eyes of 27 patients with CSC (21 females, 6 males, mean age 47 ± 11 years) were included in this retrospective study. At baseline and after 6 months after vPDT, we evaluated VD of the superficial capillary plexus (SCP), the deep capillary plexus (DCP) and the choriocapillaris (CC) in different macular areas (whole image, parafovea and fovea). We also analyzed the central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) with Enhanced Depth Imaging-Optical Coherence Tomography (EDI-OCT).
Eighteen eyes and ten eyes were responders and non responders to low-fluence vPDT, respectively. The responders group showed a significant increase in VD in DCP and CC after treatment (p < 0.05). In the non responders group the VD in SCP, DCP and CC did not differ before and after treatment. We also found a significant correlation in responders group between Best-Corrected Visual Acuity (BCVA) and CFT (r = 0.566; p = 0.014) and between BCVA and the increased VD of CC (r= -0.559; p = 0.016). In non responders group, the correlation between OCT, OCTA parameters and BCVA was not statistically significant.
OCTA allowed us to enhance our knowledge regarding the pathophysiology of vascular changes in retinal and CC networks after low-fluence vPDT. OCTA may represent a new biomarker to evaluate the efficacy of low-fluence vPDT in the treatment of CSC.
运用光学相干断层扫描血管造影(OCTA)技术,对中心性浆液性脉络膜视网膜病变(CSC)患者在接受低剂量维替泊芬光动力疗法(vPDT)后视网膜和脉络膜毛细血管的血管密度(VD)进行定量分析。
本回顾性研究纳入了27例CSC患者的28只眼睛(21例女性,6例男性,平均年龄47±11岁)。在基线期及vPDT治疗6个月后,我们评估了不同黄斑区域(全图、黄斑旁和黄斑中心凹)的浅表毛细血管丛(SCP)、深部毛细血管丛(DCP)和脉络膜毛细血管(CC)的VD。我们还使用增强深度成像光学相干断层扫描(EDI - OCT)分析了中心凹视网膜厚度(CFT)和黄斑中心凹下脉络膜厚度(SFCT)。
低剂量vPDT治疗后,分别有18只眼睛和10只眼睛为反应者和无反应者。反应者组治疗后DCP和CC的VD显著增加(p < 0.05)。在无反应者组中,SCP、DCP和CC的VD在治疗前后无差异。我们还发现反应者组中最佳矫正视力(BCVA)与CFT之间存在显著相关性(r = 0.566;p = 0.014),以及BCVA与CC增加的VD之间存在显著相关性(r = -0.559;p = 0.016)。在无反应者组中,OCT、OCTA参数与BCVA之间的相关性无统计学意义。
OCTA使我们对低剂量vPDT后视网膜和CC网络血管变化的病理生理学有了更深入的了解。OCTA可能是评估低剂量vPDT治疗CSC疗效的一种新生物标志物。