Sumnicht Andrew J, Chalam Kakarla V, Sierpina David I
Loma Linda University Eye Institute, Loma Linda University, Loma Linda, CA, USA.
Clin Ophthalmol. 2022 Sep 27;16:3145-3154. doi: 10.2147/OPTH.S359302. eCollection 2022.
Photodynamic therapy (PDT) has a niche role in treating various choroidal pathologies. PDT-induced acute exudative maculopathy (PAEM) is an uncommon complication of PDT that results in exudative retinal detachment and mild to severe decrease in vision. Successful management strategies include observation, local or systemic corticosteroids, and intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. Most cases return to visual acuity near baseline. This review summarizes what is known about PAEM to date including etiology, prevalence, management strategies, and outcomes. We conclude that management of PAEM must take into consideration various patient-specific factors. Treatment with corticosteroids or anti-VEGF agents may expedite time to recovery, though lack of randomized controlled trials preclude firm conclusions regarding a standardized approach to managing this complication of PDT.
光动力疗法(PDT)在治疗各种脉络膜疾病中具有特定作用。PDT诱导的急性渗出性黄斑病变(PAEM)是PDT一种不常见的并发症,可导致渗出性视网膜脱离以及视力轻至重度下降。成功的管理策略包括观察、局部或全身使用皮质类固醇以及玻璃体内注射抗血管内皮生长因子(抗VEGF)。大多数病例的视力恢复至接近基线水平。本综述总结了迄今为止关于PAEM的已知信息,包括病因、患病率、管理策略和结局。我们得出结论,PAEM的管理必须考虑各种患者特异性因素。使用皮质类固醇或抗VEGF药物治疗可能会加快恢复时间,尽管缺乏随机对照试验,无法就管理PDT这种并发症的标准化方法得出确凿结论。