Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Institute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine, University of Cologne, Cologne, Germany.
BMC Ophthalmol. 2024 Jan 4;24(1):8. doi: 10.1186/s12886-023-03274-9.
To compare real-life anatomical and functional outcomes of half-dose photodynamic therapy (HD-PDT) and 577 nm subthreshold pulse laser therapy (SPL) in treatment-naïve patients with central serous chorioretinopathy (CSC).
We retrospectively reviewed consecutive treatment-naïve CSC patients with non-resolving subretinal fluid (SRF) for more than 2 months who received either HD-PDT or SPL treatment. One repetition of the same treatment was allowed in patients with persistent SRF after first treatment. Functional and anatomical outcomes were assessed after first treatment and at final visit.
We included 95 patients (HD-PDT group, n = 49; SPL group, n = 46). Complete resolution of SRF after a single treatment was observed in 42.9% of HD-PDT-treated patients (n = 21; median time to resolution 7.1 weeks) and in 41.3% of SPL-treated patients (n = 19; median time to resolution 7.0 weeks). In the HD-PDT-group, 44.9% of patients (n = 22) and in the SPL-group, 43.5% (n = 20) of patients, received a second treatment due to persistent SRF, while 12.2% (n = 6) and 15.2% (n = 7), respectively, opted against a second treatment despite persistent SRF. After the final treatment, complete SRF resolution was observed in 61.2% of all HD-PDT-treated patients (n = 30; median time to resolution 8.8 weeks) and 60.9% of all SPL-treated patients (n = 28; median time to resolution 13.7 weeks, p = 0.876). In the final visit, both groups showed significant improvement of BCVA in comparison to baseline (p < 0.001 for all). The change in BCVA from baseline to final visit was similar for the two groups (HD-PDT, median BCVA change 0.10 logMAR (IQR: 0.0-0.2); in SPL group, median BCVA change 0.10 logMAR (IQR: 0.0-0.2), P = 0.344). The CSC subclassification (simple versus complex) had no influence on the anatomical or functional outcome.
High-density 577 nm SPL resulted in as good anatomical and functional treatment as HD-PDT and may thus represent a treatment alternative to HD-PDT in CSC.
比较半剂量光动力疗法（HD-PDT）和 577nm 亚阈值脉冲激光疗法（SPL）在未经治疗的中心性浆液性脉络膜视网膜病变（CSC）患者中的真实解剖学和功能结局。
我们回顾性分析了连续接受治疗的未经治疗的 CSC 患者，这些患者的视网膜下液（SRF）持续存在超过 2 个月，他们接受了 HD-PDT 或 SPL 治疗。在第一次治疗后仍有 SRF 持续存在的患者中，允许进行一次相同的治疗。在第一次治疗后和最后一次就诊时评估功能和解剖学结果。
我们纳入了 95 名患者（HD-PDT 组，n=49；SPL 组，n=46）。单次治疗后，42.9%（n=21）的 HD-PDT 治疗患者和 41.3%（n=19）的 SPL 治疗患者完全缓解了 SRF，中位缓解时间分别为 7.1 周和 7.0 周。在 HD-PDT 组中，44.9%（n=22）的患者和 SPL 组中，43.5%（n=20）的患者由于持续存在 SRF 而接受了第二次治疗，而 12.2%（n=6）和 15.2%（n=7）的患者分别在持续存在 SRF 的情况下选择不进行第二次治疗。在最后一次治疗后，所有接受 HD-PDT 治疗的患者中，61.2%（n=30）的患者完全缓解了 SRF，中位缓解时间为 8.8 周，所有接受 SPL 治疗的患者中，60.9%（n=28）的患者完全缓解了 SRF，中位缓解时间为 13.7 周，两组之间的差异无统计学意义（p=0.876）。在最后一次就诊时，两组患者的 BCVA 均较基线显著改善（p<0.001）。两组患者从基线到最后一次就诊时的 BCVA 变化相似（HD-PDT 组，中位 BCVA 变化 0.10 logMAR（IQR：0.0-0.2）；SPL 组，中位 BCVA 变化 0.10 logMAR（IQR：0.0-0.2），P=0.344）。CSC 的亚分类（单纯型与复杂型）对解剖学或功能结果没有影响。
高密度 577nm SPL 的治疗效果与 HD-PDT 相当，因此在 CSC 中可能是 HD-PDT 的替代治疗方法。
