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用宽视野光学相干断层扫描评估光动力疗法治疗中心性浆液性脉络膜视网膜病变后一年的脉络膜厚度变化。

One-year choroidal thickness changes after photodynamic therapy for central serous chorioretinopathy evaluated by widefield optical coherence tomography.

机构信息

Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2024 Dec;262(12):3805-3814. doi: 10.1007/s00417-024-06578-8. Epub 2024 Jul 12.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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