Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, South Korea.
Yeungnam Eye Center, Yeungnam University Hospital, Daegu, South Korea.
Br J Ophthalmol. 2021 Jun;105(6):844-849. doi: 10.1136/bjophthalmol-2020-316837. Epub 2020 Jul 29.
To investigate the lowest effective fluence rate of photodynamic therapy (PDT) for treating chronic central serous chorioretinopathy (CSC).
Fifty-one eyes of 51 patients with chronic CSC were randomly treated with 30% (n=15), 40% (n=16) or 50% (n=17) of the standard-fluence rate of PDT and followed up for 12 months. The success rate, recurrence rate, mean best-corrected visual acuity (BCVA), central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), integrity of the outer retinal layer and complications were evaluated at baseline and at the follow-up periods after PDT.
The rate of complete subretinal fluid (SRF) resolution in the 30%-fluence, 40%-fluence and 50%-fluence groups was 60.0%, 81.2% and 100.0%, respectively, at 3 months (p=0.009), and 80.0%, 94.0% and 100.0%, respectively, at 12 months (p=0.06). The recurrence rate in the 50%-fluence group was lower than that in the 30%- and 40%-fluence groups at 12 months (30% vs 50%, 40% vs 50%; p=0.002, p=0.030, respectively (log-rank test)). The mean BCVA improved significantly 12 months after PDT only in the 40%- and 50%-fluence groups (p=0.005, p=0.003, respectively). Mean CFT and SFCT decreased significantly at 12 months in the three groups. The rate of complications did not differ significantly among the three groups.
A 50%-fluence rate of PDT seems to be the most effective for treating chronic CSC, considering the low recurrence rate and high rate of complete SRF resolution, compared with other low-fluence PDT.
NCT01630863.
研究光动力疗法（PDT）治疗慢性中心性浆液性脉络膜视网膜病变（CSC）的最低有效光密度。
51 例（51 眼）慢性 CSC 患者随机接受 30%（n=15）、40%（n=16）或 50%（n=17）标准光密度 PDT 治疗，并随访 12 个月。评估 PDT 前后的成功率、复发率、最佳矫正视力（BCVA）均值、中心凹视网膜下厚度（CFT）、中心凹下脉络膜厚度（SFCT）、外视网膜层完整性和并发症。
3 个月时，30%、40%和 50%光密度组完全消退 SRF 的比例分别为 60.0%、81.2%和 100.0%（p=0.009），12 个月时分别为 80.0%、94.0%和 100.0%（p=0.06）。12 个月时，50%光密度组的复发率低于 30%和 40%光密度组（30%比 50%，40%比 50%；p=0.002，p=0.030，log-rank 检验）。只有在 40%和 50%光密度组，12 个月时 BCVA 显著提高（p=0.005，p=0.003）。三组的平均 CFT 和 SFCT 在 12 个月时均显著降低。三组间并发症发生率无显著差异。
与其他低光密度 PDT 相比，50%的 PDT 光密度似乎是治疗慢性 CSC 的最有效方法，因为其复发率低，完全消退 SRF 的比例高。
NCT01630863。
