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选择性视网膜治疗对贝伐单抗耐药性慢性中心性浆液性脉络膜视网膜病变的疗效。

The Effect of Selective Retina Therapy for Bevacizumab-Resistant Chronic Central Serous Chorioretinopathy.

机构信息

Department of Ophthalmology and Visual Science, Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Ophthalmologica. 2022;245(1):91-100. doi: 10.1159/000520187. Epub 2021 Oct 14.

Abstract

PURPOSE

The aim of this study was to evaluate the efficacy of selective retina therapy (SRT), used in conjunction with real-time feedback dosimetry (RFD), in the treatment of bevacizumab-resistant chronic central serous chorioretinopathy (CSC).

PATIENTS AND METHODS

In this retrospective cohort study, 22 eyes of 22 patients with bevacizumab-resistant chronic CSC, showing focal or diffuse foveal leakages on fundus fluorescein angiography (FFA), were included. After evaluation of the test spots at temporal arcades, SRT (wavelength, 527 nm; pulse repetition rate, 100 Hz; ramping over maximal 15 micropulses; and spot diameter, 200 μm) using RFD was applied to the leakage sites observed on FFA. Changes in the mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 1, 3, 6, 9, and 12 months following treatment.

RESULTS

SRF completely resolved in 81.8% (18/22 eyes) cases at 12 months post-treatment. The mean BCVA (logarithm of the minimum angle of resolution [logMAR]) improved from 0.49 ± 0.29 at baseline to 0.43 ± 0.36 at 12 months (p = 0.067). The mean BCVA gain was 0.06 logMAR, equivalent to 3 ETDRS letters. The CMT significantly decreased from 323 ± 85.6 μm at baseline to 221.5 ± 60.4 μm at 12 months (p < 0.001). The mean SRF height also significantly decreased from 174.6 ± 86.4 μm at baseline to 35.1 ± 75.4 μm at 12 months (p < 0.001).

CONCLUSION

SRT showed favorable visual and anatomical outcomes in patients with bevacizumab-resistant chronic CSC.

摘要

目的

本研究旨在评估联合实时反馈剂量测定(RFD)的选择性视网膜光凝(SRT)治疗贝伐单抗耐药性慢性中心性浆液性脉络膜视网膜病变(CSC)的疗效。

患者和方法

在这项回顾性队列研究中,纳入了 22 名患者(22 只眼)的资料,这些患者均患有贝伐单抗耐药性慢性 CSC,眼底荧光血管造影(FFA)显示局灶性或弥漫性黄斑区渗漏。在颞弓测试点评估后,在 FFA 观察到渗漏部位应用 RFD 的 SRT(波长 527nm;脉冲重复率 100Hz;最大 15 个微脉冲斜坡;光斑直径 200μm)。治疗后 1、3、6、9 和 12 个月,评估平均最佳矫正视力(BCVA)、中心黄斑厚度(CMT)和视网膜下液(SRF)高度的变化。

结果

治疗 12 个月后,81.8%(18/22 只眼)的病例 SRF 完全消退。平均 BCVA(最小分辨角对数[logMAR])从基线时的 0.49±0.29 提高到 12 个月时的 0.43±0.36(p=0.067)。平均 BCVA 提高了 0.06 logMAR,相当于 3 个 ETDRS 字母。CMT 从基线时的 323±85.6μm 显著降低到 12 个月时的 221.5±60.4μm(p<0.001)。平均 SRF 高度也从基线时的 174.6±86.4μm 显著降低到 12 个月时的 35.1±75.4μm(p<0.001)。

结论

SRT 对贝伐单抗耐药性慢性 CSC 患者显示出良好的视力和解剖学结果。

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