Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Stem cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran; Finetech in Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran.
Photodiagnosis Photodyn Ther. 2024 Aug;48:104224. doi: 10.1016/j.pdpdt.2024.104224. Epub 2024 May 25.
To determine the clinical and imaging biomarkers of the response to half-dose photodynamic therapy (HD-PDT) in patients with central serous chorioretinopathy (CSC) METHODS: Clinical records and baseline ophthalmic images of 67 chronic CSC patients who underwent HD-PDT were assessed. In addition to demographic data, optical coherence tomography (OCT), fluorescein angiography (FA) and fundus autofluorescence (FAF) images were analyzed for specific biomarkers. The patients were categorized to early responder and late responder based on the time needed for complete resolution of subretinal fluid after PDT (less than 1 month vs. more than 1 month). The baseline clinical and imaging biomarkers were compared between the two groups.
Seventy-three eyes of 67 patients were included in the study. The mean response time to PDT was 1.63 ± 1.48 months with 82.2% (60/73) of eyes categorized as early responder. The mean response time to PDT in delayed-response group was 4.15±1.51 months. In multivariate analysis, delayed response to PDT was associated with lacking history of systemic corticosteroid consumption, lacking history of pretreatment with eplerenone or acetazolamide before PDT and presence of hyperreflective foci in baseline OCT images (all p values < 0.05). There was no association between final visual outcome and late response to PDT.
The presence of inflammatory biomarkers such as hyperreflective foci in baseline OCT images might be indicative of resistance to PDT. Moreover, the effect of pretreatment with mineralocorticoid antagonist on the response to PDT in chronic CSC should be explored in future prospective studies.
确定中浆患者接受半剂量光动力疗法（HD-PDT）治疗的临床和影像学生物标志物。
对 67 例接受 HD-PDT 治疗的慢性中浆患者的临床记录和基线眼科图像进行评估。除了人口统计学数据外，还对光学相干断层扫描（OCT）、荧光素血管造影（FA）和眼底自发荧光（FAF）图像进行分析，以确定特定的生物标志物。根据 PDT 后视网膜下液完全消退所需的时间（<1 个月与>1 个月），将患者分为早期应答者和晚期应答者。比较两组之间的基线临床和影像学生物标志物。
本研究共纳入 67 例患者的 73 只眼。PDT 的平均反应时间为 1.63±1.48 个月，82.2%（60/73）的眼被归类为早期应答者。延迟反应组的平均反应时间为 4.15±1.51 个月。多因素分析显示，PDT 延迟反应与缺乏全身皮质激素使用史、缺乏 PDT 前依普利酮或乙酰唑胺预处理史以及基线 OCT 图像中存在高反射病灶有关（均 p 值<0.05）。最终视力结局与 PDT 延迟反应之间无相关性。
基线 OCT 图像中存在炎症生物标志物（如高反射病灶）可能提示对 PDT 的抵抗。此外，在未来的前瞻性研究中应探讨皮质激素拮抗剂预处理对慢性中浆患者 PDT 反应的影响。
