Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.
Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, California, USA.
Am J Ophthalmol. 2020 Sep;217:104-113. doi: 10.1016/j.ajo.2020.04.022. Epub 2020 Apr 28.
To study the early anatomic choroidal alterations in eyes with chronic central serous chorioretinopathy (CSCR) undergoing photodynamic therapy (PDT).
Multicenter retrospective cohort study.
A total of 77 patients and 81 eyes with chronic CSCR treated with PDT and 64 untreated fellow eyes were evaluated. Central macular thickness (CMT) and choroidal features including subfoveal choroidal thickness (SFCT), total choroidal area (TCA), luminal choroidal area (LCA), and stromal choroidal area (SCA) were analyzed. Choroidal vascularity index (CVI) was calculated in all study eyes at baseline and at 1- and 3-months post-PDT.
In eyes receiving PDT, Snellen visual acuity (VA) significantly improved at months 1 and 3 (P < .001). CMT and SFCT showed a significant reduction from baseline at months 1 and 3 (P < .001), whereas TCA and LCA showed a significant decrease only at the 1-month follow-up visit. Baseline mean TCA and LCA were 2.30 ± 1.41 mm and 1.23 ± 0.73 mm, respectively, and decreased to 2.07 ± 1.21 mm and 1.08 ± 0.63 mm at the 1-month follow-up visit, respectively (P = .01). No significant changes were recorded for SCA and CVI. In the fellow eye group, VA, CMT, and all choroidal parameters showed no differences between baseline and any follow-up visits (all P > .05).
After PDT for chronic CSCR we observed sustained reductions in CMT and SFCT, while reductions in TCA and LCA were only noted at the 1-month follow-up interval. These choroidal parameters may provide additional quantitative biomarkers to evaluate the anatomic response to therapy but await further prospective validation.
研究接受光动力疗法（PDT）治疗的慢性中心性浆液性脉络膜视网膜病变（CSCR）患者眼睛的早期解剖脉络膜改变。
多中心回顾性队列研究。
共评估了 77 例患者的 81 只眼和 64 只未经治疗的对侧眼，这些眼均接受 PDT 治疗慢性 CSCR。分析了中央黄斑厚度（CMT）和脉络膜特征，包括中心凹下脉络膜厚度（SFCT）、总脉络膜面积（TCA）、管腔脉络膜面积（LCA）和基质脉络膜面积（SCA）。所有研究眼均在基线和 PDT 后 1 个月和 3 个月时计算脉络膜血管指数（CVI）。
接受 PDT 的眼，视力（VA）在 1 个月和 3 个月时明显提高（P <.001）。CMT 和 SFCT 在 1 个月和 3 个月时与基线相比均显著降低（P <.001），而 TCA 和 LCA 仅在 1 个月随访时显著降低。基线时平均 TCA 和 LCA 分别为 2.30 ± 1.41mm 和 1.23 ± 0.73mm，1 个月随访时分别降至 2.07 ± 1.21mm 和 1.08 ± 0.63mm（P =.01）。SCA 和 CVI 无明显变化。对侧眼组，VA、CMT 和所有脉络膜参数在基线和任何随访时间均无差异（均 P >.05）。
慢性 CSCR 接受 PDT 治疗后，我们观察到 CMT 和 SFCT 持续降低，而 TCA 和 LCA 仅在 1 个月随访时降低。这些脉络膜参数可能为评估治疗的解剖反应提供额外的定量生物标志物，但需要进一步的前瞻性验证。
