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预测中心性浆液性脉络膜视网膜病变患者良好基线视力下低强度光动力疗法治疗后出现变形性幻视的因素。

Predictive factors of metamorphopsia after reduced-fluence photodynamic therapy in patients with central serous chorioretinopathy with good baseline visual acuity.

机构信息

Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

出版信息

PLoS One. 2020 Oct 12;15(10):e0240557. doi: 10.1371/journal.pone.0240557. eCollection 2020.

Abstract

This retrospective study was conducted to investigate the predictive factors associated with metamorphopsia after reduced-fluence photodynamic therapy (RFPDT) in patients with central serous chorioretinopathy (CSC) with good baseline visual acuity. A total of 36 eyes of 36 consecutive patients with resolved CSC after RFPDT and best-corrected visual acuity (BCVA) better than 1.0 (logarithm of the minimal angle of resolution (logMAR) 0) at baseline were examined. Metamorphopsia was measured using M-CHARTS at 12 months after RFPDT. An average of the horizontal and vertical M-CHARTS scores was applied for defining the extent of metamorphopsia. The association between M-CHARTS score at 12 months after RFPDT and clinical parameters (age, sex, duration of symptoms, BCVA, and findings of optical coherence tomography (OCT)) was investigated at baseline or 12 months after RFPDT. The M-CHARTS score at 12 months correlated significantly with duration of symptoms (P = 0.005), baseline outer nuclear layer (ONL) thickness (P = 0.009), central foveal thickness (CFT) (P = 0.001) at 12 months, and ONL thickness (P = 0.001) at 12 months after RFPDT. In the multivariate analysis of baseline-related factors, thinner ONL thickness before RFPDT (P = 0.010) was significantly associated with large metamorphopsia at 12 months after RFPDT in CSC patients with good baseline BCVA. Baseline ONL thickness may be a useful predictive factor of metamorphopsia after RFPDT in CSC patients with good baseline BCVA.

摘要

这项回顾性研究旨在探讨中心性浆液性脉络膜视网膜病变(CSC)患者经低强度光动力疗法(RFPDT)治疗后,视力基线良好(最佳矫正视力(BCVA)优于 1.0,即最小分辨角对数(logMAR)为 0),且病变已消退,预测与光动力疗法后发生视物变形相关的因素。共纳入 36 例(36 只眼)经 RFPDT 治疗且病变消退,且基线 BCVA 优于 1.0(logMAR 0)的 CSC 患者。于 RFPDT 后 12 个月采用 M-CHARTS 评估患者的视物变形情况。采用水平和垂直 M-CHARTS 评分的平均值定义视物变形的程度。于 RFPDT 前后(基线时或 RFPDT 后 12 个月),分析 RFPDT 后 12 个月时 M-CHARTS 评分与临床参数(年龄、性别、症状持续时间、BCVA 和光学相干断层扫描(OCT)结果)之间的相关性。RFPDT 后 12 个月时的 M-CHARTS 评分与症状持续时间(P = 0.005)、基线时外核层(ONL)厚度(P = 0.009)、12 个月时中央凹视网膜厚度(CFT)(P = 0.001)和 RFPDT 后 12 个月时的 ONL 厚度(P = 0.001)显著相关。在与基线相关的多因素分析中,RFPDT 前更薄的 ONL 厚度(P = 0.010)与 CSC 患者 RFPDT 后 12 个月的大视物变形显著相关,这些患者的 BCVA 基线良好。RFPDT 后 BCVA 基线良好的 CSC 患者,基线时的 ONL 厚度可能是预测光动力疗法后发生视物变形的有用因素。

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