中心性浆液性脉络膜视网膜病变患者光动力治疗后视力丧失相关特征。
Characteristics Related to Visual Acuity Loss After Successful Photodynamic Therapy for Eyes With Central Serous Chorioretinopathy.
机构信息
From the Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan (R.F., H.T., S.S., H.S., N.M., T.S.).
From the Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan (R.F., H.T., S.S., H.S., N.M., T.S.).
出版信息
Am J Ophthalmol. 2023 Dec;256:164-174. doi: 10.1016/j.ajo.2023.05.022. Epub 2023 Jun 17.
PURPOSE
This study aimed to examine baseline characteristics for identifying factors associated with vision loss (VL) in patients with central serous chorioretinopathy (CSC) who successfully responded to photodynamic therapy (PDT).
DESIGN
A retrospective, clinical case-control study.
METHODS
This study included 85 eyes with CSC, which underwent PDT, and resolved serous retinal detachment. These eyes were classified into 2 groups: the VL group (best-corrected visual acuity 6 months after PDT was worse than that at baseline) and the vision maintenance or improved group (the others). Baseline factors were analyzed to determine the characteristics of the VL group and assess the diagnostic potential of these factors.
RESULT
Seventeen eyes were included in the VL group. The mean values of the neurosensory retinal (NSR) thickness, the internal limiting membrane-external limiting membrane thickness (IET), and the external limiting membrane-photoreceptor outer segment thickness (EOT) in the VL group were significantly thinner than those in the vision maintenance or improved group (NSR thickness, 123.2 ± 39.7 µm vs 166.3 ± 49.6 µm, P < .001; IET, 63.1 ± 17.0 µm vs 88.0 ± 25.4 µm, P < .001; EOT, 60.1 ± 28.6 µm vs 78.3 ± 33.1, P = .041). The sensitivity, specificity, and positive and negative predictive values for predicting VL were 94.1%, 50.0%, 32.0%, and 97.1% for NSR thickness; 94.1%, 51.5%, 32.7%, and 97.2% for IET; and 94.1%, 30.9%, 25.4%, and 95.5% for EOT, respectively.
CONCLUSIONS
Pretreatment sensory retinal layer thickness could predict VL after PDT for CSC and may be a helpful reference for PDT.
目的
本研究旨在探讨与接受光动力疗法（PDT）治疗后成功缓解的中心性浆液性脉络膜视网膜病变（CSC）患者视力丧失（VL）相关的基线特征。
设计
回顾性临床病例对照研究。
方法
纳入 85 例接受 PDT 治疗并缓解浆液性视网膜脱离的 CSC 患者的 85 只眼。这些眼分为 2 组：VL 组（PDT 治疗后 6 个月最佳矫正视力较基线时下降）和视力维持或改善组（其他）。分析基线因素以确定 VL 组的特征，并评估这些因素的诊断潜力。
结果
VL 组包括 17 只眼。VL 组的神经感觉视网膜（NSR）厚度、内界膜-外界膜厚度（IET）和外界膜-光感受器外节厚度（EOT）的平均值明显小于视力维持或改善组（NSR 厚度，123.2±39.7μm 比 166.3±49.6μm，P<0.001；IET，63.1±17.0μm 比 88.0±25.4μm，P<0.001；EOT，60.1±28.6μm 比 78.3±33.1μm，P=0.041）。NSR 厚度预测 VL 的灵敏度、特异性、阳性预测值和阴性预测值分别为 94.1%、50.0%、32.0%和 97.1%；IET 分别为 94.1%、51.5%、32.7%和 97.2%；EOT 分别为 94.1%、30.9%、25.4%和 95.5%。
结论
治疗前感觉视网膜层厚度可预测 CSC 患者接受 PDT 治疗后的 VL，可能是 PDT 的有用参考指标。
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