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慢性中心性浆液性脉络膜视网膜病变患者半剂量光动力疗法后的微观结构变化。

Microstructural changes after half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy.

机构信息

Department of Ophthalmology, School of Medicine, Cukurova University, Adana, Turkey.

出版信息

Photodiagnosis Photodyn Ther. 2021 Sep;35:102347. doi: 10.1016/j.pdpdt.2021.102347. Epub 2021 May 24.

DOI:10.1016/j.pdpdt.2021.102347
PMID:34033938
Abstract

BACKGROUND

To evaluate the retinal and choroidal microstructural changes at fovea after half-dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (CSC), using optical coherence tomography (OCT).

METHODS

The study included 35 eyes with unilateral chronic CSC treated with half-dose PDT. The foveal outer nuclear layer (ONL) and subfoveal choroidal thickness (SFCT) in the affected eyes were compared with baseline measurements at month 1, 3, and 6 after half-dose PDT, and those of the healthy contralateral eyes.

RESULTS

The mean baseline ONL thickness of the affected eyes was thinner compared to unaffected fellow eyes (66.9 ± 16.5 μm vs 111.5 ± 11.6 μm, p<0.001), and increased significantly to 68.6 ± 17.0 μm at month 3 and 68.9 ± 17.3 μm at month 6 after treatment (p = 0.025 and p = 0.014 respectively). The mean baseline SFCT of the affected eyes was thicker compared to unaffected fellow eyes (399.9 ± 87.0 μm vs 338.2 ± 75.4 μm, p<0.001), and decreased significantly after treatment at month 1, 3, and 6 (374.0 ± 84.8 μm, 369.7 ± 81.8 μm, 367.3 ± 80.8 μm respectively, p<0.001 for all). The responder group (n = 26), in which subretinal fluid was completely resorbed, showed a significant increase in ONL thickness and decrease in SFCT after treatment, whereas in the non-responder group (n = 9) ONL thickness and SFCT did not differ after treatment.

CONCLUSIONS

In CSC patients, significant changes are observed in foveal ONL thickness and SFCT after half-dose PDT. ONL thickness and SFCT are suggested to be considered in the OCT examinations of CSC patients.

摘要

背景

利用光学相干断层扫描(OCT)评估慢性中心性浆液性脉络膜视网膜病变(CSC)患者半剂量光动力疗法(PDT)后黄斑区视网膜和脉络膜的微观结构变化。

方法

本研究纳入了 35 只单侧慢性 CSC 患眼,均接受半剂量 PDT 治疗。治疗后 1、3、6 个月,测量患眼黄斑区外核层(ONL)和黄斑中心凹下脉络膜厚度(SFCT),并与基线水平和对侧健康眼进行比较。

结果

与对侧未受影响的眼相比,患眼的平均基线 ONL 厚度较薄(66.9±16.5μm 比 111.5±11.6μm,p<0.001),治疗后 3 个月和 6 个月时,ONL 厚度分别显著增加至 68.6±17.0μm 和 68.9±17.3μm(p=0.025 和 p=0.014)。与对侧未受影响的眼相比,患眼的平均基线 SFCT 较厚(399.9±87.0μm 比 338.2±75.4μm,p<0.001),治疗后 1、3、6 个月时,SFCT 显著降低(374.0±84.8μm、369.7±81.8μm、367.3±80.8μm,均 p<0.001)。在完全吸收视网膜下液的应答者组(n=26)中,ONL 厚度增加,SFCT 降低;而在无应答者组(n=9)中,治疗后 ONL 厚度和 SFCT 无差异。

结论

在 CSC 患者中,半剂量 PDT 后黄斑区 ONL 厚度和 SFCT 发生明显变化。在 OCT 检查中,应考虑 ONL 厚度和 SFCT 这两个参数。

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