Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan.
Graefes Arch Clin Exp Ophthalmol. 2024 Dec;262(12):3805-3814. doi: 10.1007/s00417-024-06578-8. Epub 2024 Jul 12.
To evaluate the changes in choroidal thickness 1 year after half-dose photodynamic therapy (PDT) for central serous chorioretinopathy (CSC) using widefield swept-source optical coherence tomography.
We retrospectively reviewed 21 patients with CSC who unilaterally underwent half-dose PDT and completed a 12-month follow-up. Choroidal thickness was evaluated before and after PDT within an 18-mm circular grid centered on the fovea subdivided into nine areas in the treated and untreated fellow eyes.
All 21 treated eyes showed complete resolution of subretinal fluid at 3 months after PDT, without any recurrence at 12 months. The mean choroidal thickness in all nine areas significantly decreased after PDT at 3 months (P < 0.05) and remained unchanged at 12 months (P < 0.05) compared with that at baseline. However, the subtracted choroidal thickness maps between 3 and 12 months detected significant variations among the cases, classified into an enhanced pattern in 10 eyes (47.6%), an attenuated pattern in six eyes (28.6%), and a stable pattern in five eyes (23.8%). The 21 untreated fellow eyes also showed a decrease in mean choroidal thickness in three of the nine subdivided areas at 12 months (P < 0.05), but this decrease was limited posteriorly.
The reduction in mean choroidal thickness after half-dose PDT for CSC was extensively maintained for 1 year. However, subclinical hemodynamic changes in the entire choroid occurred longitudinally even in the absence of disease recurrence.
使用广角扫频源光学相干断层扫描评估中浆性脉络膜视网膜病变(CSC)半剂量光动力疗法(PDT)治疗 1 年后脉络膜厚度的变化。
我们回顾性分析了 21 例单侧接受半剂量 PDT 治疗并完成 12 个月随访的 CSC 患者。在以黄斑为中心的 18mm 圆形网格内评估 PDT 前后脉络膜厚度,将治疗眼和未治疗眼分为 9 个区域。
所有 21 只治疗眼在 PDT 后 3 个月均完全消退视网膜下积液,12 个月内无复发。与基线相比,所有 9 个区域的平均脉络膜厚度在 PDT 后 3 个月(P<0.05)显著降低,12 个月时保持不变(P<0.05)。然而,在 3 至 12 个月之间的减去脉络膜厚度图中,发现病例之间存在显著差异,分为增强模式 10 只眼(47.6%)、衰减模式 6 只眼(28.6%)和稳定模式 5 只眼(23.8%)。21 只未治疗的对侧眼在 12 个月时也有 3 个分区的平均脉络膜厚度减少(P<0.05),但这种减少仅限于后部。
CSC 半剂量 PDT 治疗后平均脉络膜厚度的减少在 1 年内得到广泛维持。然而,即使没有疾病复发,整个脉络膜的亚临床血流动力学变化也会发生纵向变化。