Department of Ophthalmology, Centro Hospitalar Universitário de São João, Porto, Portugal.
Department of Ophthalmology, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.
Photodiagnosis Photodyn Ther. 2021 Jun;34:102235. doi: 10.1016/j.pdpdt.2021.102235. Epub 2021 Feb 22.
To evaluate long-term changes in the foveal and parafoveal outer retina after half-dose photodynamic therapy (HD-PDT) in central serous chorioretinopathy (CSC).
Retrospective study including CSC patients submitted to HD-PDT. Best corrected visual acuity (BCVA) was evaluated. Spectral-domain optical coherence tomography automatic segmentation algorithm was used and data on retinal, inner retinal, outer retinal and outer nuclear layers (ONL) in both foveal 1 mm (C) and parafoveal 3 mm ETDRS circles for the superior, nasal, inferior and temporal sectors, were obtained at baseline and 3, 12 and 24 months post-treatment. Subfoveal choroidal thickness, photoreceptors' outer segment thickness, subretinal fluid (SRF) height and width were also measured.
Twenty-one eyes of 15 patients were included. At baseline, the mean ONL thickness in the foveal area was significantly thinner in affected eyes compared to their fellow unaffected ones (55,50 ± 32,75 μm vs 93,00 ± 17,0 μm; p = 0,011), and was negatively correlated to logMAR BCVA (R=-0,601, p = 0,008) ONL thickness increased by 10,94 ± 11,88 μm at 24 months in the foveal area, and all the parafoveal sectors presented a similar increase. Baseline SRF width was significantly correlated with baseline BCVA (R1 = 0,483, p = 0,036), and with ONL thickness in all sectors.
In our study we found a significant long-term increase in foveal and parafoveal ONL thickness in CSC after HD-PDT, suggesting that this seems to be a safe treatment for the outer retina. This is the first study mapping the outer retinal changes in the macular area to 24 months follow up.
评估半剂量光动力疗法（HD-PDT）治疗中心性浆液性脉络膜视网膜病变（CSC）后黄斑及旁中心凹外视网膜的长期变化。
回顾性研究纳入了接受 HD-PDT 的 CSC 患者。评估最佳矫正视力（BCVA）。采用频域光相干断层扫描自动分割算法，获得治疗前及治疗后 3、12 和 24 个月时黄斑中心 1mm（C）和旁中心 3mm ETDRS 环的视网膜、内视网膜、外视网膜和外核层（ONL）的视网膜、内视网膜、外视网膜和外核层（ONL）的数据，并分别测量黄斑下脉络膜厚度、光感受器外节厚度、视网膜下液（SRF）高度和宽度。
共纳入 15 例患者的 21 只眼。治疗前，受累眼黄斑区 ONL 厚度明显薄于对侧眼（55.50 ± 32.75μm vs 93.00 ± 17.0μm；p = 0.011），且与 logMAR BCVA 呈负相关（R=-0.601，p = 0.008）。治疗后 24 个月时，黄斑区 ONL 厚度增加 10.94 ± 11.88μm，所有旁中心凹区均有类似增加。治疗前 SRF 宽度与治疗前 BCVA 呈显著正相关（R1 = 0.483，p = 0.036），与各象限 ONL 厚度均呈显著正相关。
我们的研究发现，CSC 患者接受 HD-PDT 治疗后黄斑及旁中心凹外视网膜的 ONL 厚度有显著的长期增加，提示这种治疗方法似乎对外视网膜是安全的。这是首次对黄斑区外视网膜进行长达 24 个月随访的研究。
