半剂量光动力疗法联合依普利酮治疗慢性中心性浆液性脉络膜视网膜病变的长期疗效：一项对比研究。

Long-term outcomes of half-fluence photodynamic therapy and eplerenone in chronic central serous chorioretinopathy: A comparative study.

机构信息

Department of Retina and Vitreous Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India.

Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, Hyderabad Eye Research Foundation, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India.

出版信息

Eur J Ophthalmol. 2021 Nov;31(6):3110-3116. doi: 10.1177/1120672121991053. Epub 2021 Jan 28.

DOI:10.1177/1120672121991053

PMID:33508971

Abstract

AIMS

To compare the long-term outcomes in chronic central serous chorioretinopathy (cCSC) following half-fluence photodynamic therapy (HF-PDT) and oral eplerenone treatment.

METHODS

This retrospective comparative study included consecutive patients of cCSC treated with either HF-PDT or eplerenone. The treatment outcomes of the two groups were analyzed at 3-month, 6-month, and 12-month post-treatment.

RESULTS

This study included 20 eyes (20 patients) in HF-PDT group, and 18 eyes (18 patients) in eplerenone group. All baseline parameters in HF-PDT and eplerenone groups were comparable including neurosensory detachment height (217.05 ± 140.25 µm vs 178.05 ± 164.24 µm respectively, = 0.09), best-corrected visual acuity (BCVA) (logMAR 0.24 ± 0.13 vs logMAR 0.46 ± 0.37 respectively, = 0.1), and subfoveal choroidal thickness (SFCT) [427.4 ± 117.4 µm vs 456.38 ± 119.25 µm respectively, = 0.45]. HF-PDT resulted in complete resolution of neurosensory detachment in higher proportion of eyes compared to eplerenone at each follow-up visits (3 months: 90% vs 27.7%, = 0; 6 months: 100% vs 61.1%, = 0.003; and 12 months: 100% vs 70%, = 0.03) with a significantly shorter duration to resolution (3.3 ± 0.9 months vs 5.8 ± 3.3 months respectively, = 0.02). Intergroup comparison showed no significant difference between mean BCVA ( = 0.38 at 3 months, = 0.14 at 6 months, and = 0.19 at 12 months). Mean SFCT at 12 months of the two groups differed significantly ( = 0.003) due to increased choroidal thickness of eplerenone group.

CONCLUSION

HF-PDT has a superior efficacy to achieve faster, greater and long-lasting resolution of subretinal fluid in cCSC compared to eplerenone therapy.

摘要

目的

比较半剂量光动力疗法（HF-PDT）和口服依普利酮治疗慢性中心性浆液性脉络膜视网膜病变（cCSC）的长期疗效。

方法

本回顾性对照研究纳入了接受 HF-PDT 或依普利酮治疗的 cCSC 连续患者。分析两组患者治疗后 3 个月、6 个月和 12 个月的治疗结果。

结果

该研究纳入了 HF-PDT 组的 20 只眼（20 例）和依普利酮组的 18 只眼（18 例）。HF-PDT 组和依普利酮组的所有基线参数均无差异，包括神经感觉脱离高度（分别为 217.05 ± 140.25 μm 和 178.05 ± 164.24 μm， = 0.09）、最佳矫正视力（BCVA）（logMAR 0.24 ± 0.13 和 logMAR 0.46 ± 0.37， = 0.1）和中心凹下脉络膜厚度（SFCT）[分别为 427.4 ± 117.4 μm 和 456.38 ± 119.25 μm， = 0.45]。与依普利酮相比，HF-PDT 在每个随访时间点（3 个月：90%对 27.7%， = 0；6 个月：100%对 61.1%， = 0.003；12 个月：100%对 70%， = 0.03）均有更高比例的眼完全缓解神经感觉脱离，且缓解时间更短（分别为 3.3 ± 0.9 个月和 5.8 ± 3.3 个月， = 0.02）。组间比较显示，BCVA 均值在 3 个月时差异无统计学意义（ = 0.38），6 个月时差异有统计学意义（ = 0.14），12 个月时差异有统计学意义（ = 0.19）。两组在 12 个月时的 SFCT 均值差异有统计学意义（ = 0.003），这是由于依普利酮组脉络膜厚度增加。