慢性中心性浆液性脉络膜视网膜病变半剂量和三分之一剂量维替泊芬光动力疗法后脉络膜血流减少。
Decrease in choroidal blood flow after half and one-third dose verteporfin photodynamic therapy for chronic central serous chorioretinopathy.
机构信息
Department of Ophthalmology, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
出版信息
BMC Ophthalmol. 2021 May 31;21(1):241. doi: 10.1186/s12886-021-01980-w.
BACKGROUND
The effect of various reduced doses of verteporfin photodynamic therapy (PDT) on choroidal blood flow in chronic central serous chorioretinopathy (CSC) remains unclear. Therefore, this study aimed to evaluate choroidal blood flow after half-dose PDT (1/2PDT) and one-third dose PDT (1/3PDT) with verteporfin for chronic CSC using laser speckle flowgraphy and spectral-domain optical coherence tomography.
METHODS
Twenty-seven eyes of 27 patients with serous retinal detachment (SRD) caused by chronic CSC for more than 6 months were included in this study. Patients were divided into the 1/2PDT (n = 12; January 2018 to July 2019) and 1/3PDT (n = 15; August 2016 to December 2017) groups based on the treatment period. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), central choroidal thickness (CCT), and mean blur rate in the macular area (m-MBR) and optic nerve head (ONH-MBR) were obtained using laser speckle flowgraphy and evaluated at baseline (pre-treatment), and 2 weeks, 1 month, 3 months, and 6 months after treatment.
RESULTS
We found that SRD disappeared after 1 month in 92 and 93% of patients' eyes in the 1/2PDT and 1/3PDT groups, respectively. Recurrence of SRD was observed in one eye at the 6-month follow-up after 1/2PDT and two eyes at the 3-month follow-up after 1/3PDT. No significant improvement was observed in baseline BCVA in the 1/3PDT and 1/2PDT groups. The average m-MBR against baseline significantly decreased at 2 weeks and 1, 3, and 6 months in the 1/2PDT group. The average m-MBR against baseline decreased significantly only at the 2 weeks follow-up in the 1/3PDT group. The average rate of change in the CCT against baseline decreased significantly throughout for up to 6 months in the 1/2PDT group and for up to 3 months in the 1/3PDT group. No significant fluctuation was observed in the ONH-MBR.
CONCLUSIONS
Here, PDT significantly affected choroidal blood flow depending on the verteporfin dose in chronic CSC.
TRIAL REGISTRATION
This trial was retrospectively registered ( UMIN000026850 ; Approval date 03/04/2017).
背景
不同剂量的维替泊芬光动力疗法（PDT）对慢性中心性浆液性脉络膜视网膜病变（CSC）脉络膜血流的影响尚不清楚。因此，本研究旨在使用激光散斑血流仪和频域光学相干断层扫描评估维替泊芬半剂量 PDT（1/2PDT）和三分之一剂量 PDT（1/3PDT）治疗慢性 CSC 后的脉络膜血流。
方法
本研究纳入了 27 例因慢性 CSC 导致浆液性视网膜脱离（SRD）超过 6 个月的患者的 27 只眼。根据治疗时间，患者被分为 1/2PDT 组（n=12；2018 年 1 月至 2019 年 7 月）和 1/3PDT 组（n=15；2016 年 8 月至 2017 年 12 月）。使用激光散斑血流仪获得最佳矫正视力（BCVA）、中心视网膜厚度（CRT）、中央脉络膜厚度（CCT）、黄斑区平均模糊率（m-MBR）和视神经头（ONH-MBR），并在基线（治疗前）和治疗后 2 周、1 个月、3 个月和 6 个月进行评估。
结果
我们发现，1/2PDT 组和 1/3PDT 组患者的眼睛中，分别有 92%和 93%的 SRD 在 1 个月后消失。1/2PDT 组有 1 只眼在治疗后 6 个月时出现 SRD 复发，1/3PDT 组有 2 只眼在治疗后 3 个月时出现 SRD 复发。1/3PDT 和 1/2PDT 组基线时 BCVA 无明显改善。1/2PDT 组治疗后 2 周、1 个月、3 个月和 6 个月的平均 m-MBR 与基线相比显著降低。1/3PDT 组仅在治疗后 2 周时平均 m-MBR 与基线相比显著降低。1/2PDT 组 CCT 与基线相比的平均变化率在治疗后 6 个月内显著降低，1/3PDT 组在治疗后 3 个月内显著降低。ONH-MBR 无明显波动。
结论
在这里，PDT 显著影响了慢性 CSC 中脉络膜血流，这取决于维替泊芬的剂量。
试验注册
本试验为回顾性注册（UMIN000026850；注册日期 2017 年 3 月 4 日）。
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