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持续性中心性浆液性脉络膜视网膜病变的实用治疗选择及早期视觉和解剖学结果。

Practical treatment options for persistent central serous chorioretinopathy and early visual and anatomical outcomes.

机构信息

Department of Ophthalmology and Visual Sciences, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.

出版信息

Jpn J Ophthalmol. 2023 May;67(3):295-300. doi: 10.1007/s10384-023-00978-9. Epub 2023 Mar 3.

Abstract

PURPOSE

Persistent central serous chorioretinopathy (pCSC) may be treated by laser photocoagulation (PC), selective retina therapy (SRT), or photodynamic therapy (PDT). We conducted retrospective analyses regarding the choice of therapy for pCSC in the best clinical practice and the outcomes of these modalities.

STUDY DESIGN

A retrospective interventional study.

METHODS

The records of 71 eyes of 68 treatment naïve pCSC cases who underwent PC, SRT, or PDT were reviewed. First, the baseline clinical parameters were evaluated to find significant factors associated with the choice of treatment option. Second, the 3 months' visual and anatomical outcomes of each modality were assessed.

RESULTS

The PC, SRT, and PDT groups included 7, 22, and 42 eyes, respectively. The leakage pattern in fluorescein angiography (FA) was significantly associated with the choice of treatment (p<0.005). The dry macula ratio at 3 months post-treatment was 29%, 59%, and 81% in the PC, SRT, and PDT groups, respectively, which significantly differed among the groups (p<0.01). The best-corrected visual acuities tended to be improved after the treatments in all groups. Central choroidal thickness (CCT) was significantly decreased in all groups (p<0.05, p<0.01, and p<0.00001, in PC, SRT, and PDT groups, respectively). Logistic regression analysis for dry macula revealed that SRT (p<0.05), PDT (p<0.05), and the changes in CCT (p<0.01)were the significant association factors.

CONCLUSION

The leakage pattern in FA was associated with the choice of treatment option for pCSC. PDT achieved a significantly higher dry macula ratio than PC, 3 months after the treatment.

摘要

目的

持续性中心性浆液性脉络膜视网膜病变(pCSC)可通过激光光凝(PC)、选择性视网膜光凝(SRT)或光动力疗法(PDT)进行治疗。我们回顾性分析了最佳临床实践中 pCSC 治疗选择以及这些方法的结果。

研究设计

回顾性干预研究。

方法

回顾性分析了 71 只眼 68 例初治 pCSC 患者的 PC、SRT 或 PDT 记录。首先,评估基线临床参数以找到与治疗方案选择相关的显著因素。其次,评估每种治疗方法的 3 个月视觉和解剖结果。

结果

PC、SRT 和 PDT 组分别包括 7、22 和 42 只眼。荧光素血管造影(FA)中的渗漏模式与治疗选择显著相关(p<0.005)。治疗后 3 个月,PC、SRT 和 PDT 组的干性黄斑比率分别为 29%、59%和 81%,组间差异显著(p<0.01)。所有组的最佳矫正视力均在治疗后有所改善。所有组的中央脉络膜厚度(CCT)均显著降低(p<0.05、p<0.01 和 p<0.00001,在 PC、SRT 和 PDT 组中)。干性黄斑的逻辑回归分析表明,SRT(p<0.05)、PDT(p<0.05)和 CCT 的变化(p<0.01)是显著的关联因素。

结论

FA 中的渗漏模式与 pCSC 治疗方案的选择相关。与 PC 相比,PDT 在治疗后 3 个月获得了更高的干性黄斑比率。

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