应对维替泊芬短缺：慢性及未愈性中心性浆液性脉络膜视网膜病变患者的治疗选择与结局
Dealing with the Verteporfin Shortage: Treatment Options and Outcomes in Patients with Chronic and Non-Resolving Central Serous Chorioretinopathy.
作者信息
van den Tillaart Femke M, Hartgers Franca, Hoyng Carel B, Yzer Suzanne
机构信息
Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands,
Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands.
出版信息
Ophthalmologica. 2025;248(1):11-21. doi: 10.1159/000542224. Epub 2024 Oct 24.
INTRODUCTION
Half-dose photodynamic therapy (HD-PDT) with verteporfin is the mainstay treatment in central serous chorioretinopathy (CSC). Since 2021, there is a worldwide shortage of verteporfin. This called for adjustments of daily practice. Here, we provide a comprehensive evaluation of the adapted treatment methods and outcomes in patients with non-resolving and chronic CSC.
METHODS
In this retrospective cohort study, we compared patients referred in the year before the verteporfin shortage (group 1), with patients referred in the first year of verteporfin shortage (group 2). Treatment strategies, subretinal fluid (SRF) resolution, and visual acuity (VA) were evaluated during a follow-up period of at least 4 months.
RESULTS
Eighty-five eyes of 79 patients were analyzed, 36 eyes in group 1 and 49 in group 2. The treatment strategy at the first visit shifted from HD-PDT as the most performed treatment in group 1 to a more patient-tailored approach in group 2, with a wait-and-see policy in most cases. During follow-up, HD-PDT was performed significantly less in group 2 (89% vs. 45%; p < 0.001). At a mean follow-up time of 6.2 months, SRF resolved in 61% of the eyes in group 1 and in 55% in group 2 (p = 0.821). No difference in VA was observed between the groups at follow-up (p = 0.637).
CONCLUSION
During the shortage of verteporfin, a different treatment strategy was applied, with HD-PDT being performed less frequently. By implementing a more patient-tailored approach, the VA and the resolution rate of SRF remained similar to the year before the shortage.
INTRODUCTION
Half-dose photodynamic therapy (HD-PDT) with verteporfin is the mainstay treatment in central serous chorioretinopathy (CSC). Since 2021, there is a worldwide shortage of verteporfin. This called for adjustments of daily practice. Here, we provide a comprehensive evaluation of the adapted treatment methods and outcomes in patients with non-resolving and chronic CSC.
METHODS
In this retrospective cohort study, we compared patients referred in the year before the verteporfin shortage (group 1), with patients referred in the first year of verteporfin shortage (group 2). Treatment strategies, subretinal fluid (SRF) resolution, and visual acuity (VA) were evaluated during a follow-up period of at least 4 months.
RESULTS
Eighty-five eyes of 79 patients were analyzed, 36 eyes in group 1 and 49 in group 2. The treatment strategy at the first visit shifted from HD-PDT as the most performed treatment in group 1 to a more patient-tailored approach in group 2, with a wait-and-see policy in most cases. During follow-up, HD-PDT was performed significantly less in group 2 (89% vs. 45%; p < 0.001). At a mean follow-up time of 6.2 months, SRF resolved in 61% of the eyes in group 1 and in 55% in group 2 (p = 0.821). No difference in VA was observed between the groups at follow-up (p = 0.637).
CONCLUSION
During the shortage of verteporfin, a different treatment strategy was applied, with HD-PDT being performed less frequently. By implementing a more patient-tailored approach, the VA and the resolution rate of SRF remained similar to the year before the shortage.
引言
维替泊芬半剂量光动力疗法（HD-PDT）是中心性浆液性脉络膜视网膜病变（CSC）的主要治疗方法。自2021年以来，全球出现维替泊芬短缺。这就需要对日常实践进行调整。在此，我们对非消退型和慢性CSC患者的适应性治疗方法及结果进行了全面评估。
方法
在这项回顾性队列研究中，我们比较了维替泊芬短缺前一年转诊的患者（第1组）和维替泊芬短缺第一年转诊的患者（第2组）。在至少4个月的随访期内评估治疗策略、视网膜下液（SRF）消退情况和视力（VA）。
结果
分析了79例患者的85只眼，第1组36只眼，第2组49只眼。首次就诊时的治疗策略从第1组中最常用的HD-PDT转变为第2组中更具个体化的方法，大多数情况下采取观望策略。在随访期间，第2组进行HD-PDT的次数明显减少（89%对45%；p<0.001）。平均随访时间为6.2个月时，第1组61%的眼SRF消退，第2组为55%（p=0.821）。随访时两组间VA无差异（p=0.637）。
结论
在维替泊芬短缺期间，采用了不同的治疗策略，HD-PDT的实施频率降低。通过采用更具个体化的方法，VA和SRF消退率与短缺前一年相似。
引言
维替泊芬半剂量光动力疗法（HD-PDT）是中心性浆液性脉络膜视网膜病变（CSC）的主要治疗方法。自2021年以来，全球出现维替泊芬短缺。这就需要对日常实践进行调整。在此，我们对非消退型和慢性CSC患者的适应性治疗方法及结果进行了全面评估。
方法
在这项回顾性队列研究中，我们比较了维替泊芬短缺前一年转诊的患者（第1组）和维替泊芬短缺第一年转诊的患者（第2组）。在至少4个月的随访期内评估治疗策略、视网膜下液（SRF）消退情况和视力（VA）。
结果
分析了79例患者的85只眼，第1组36只眼，第2组49只眼。首次就诊时的治疗策略从第1组中最常用的HD-PDT转变为第2组中更具个体化的方法，大多数情况下采取观望策略。在随访期间，第2组进行HD-PDT的次数明显减少（89%对45%；p<0.001）。平均随访时间为6.2个月时，第1组61%的眼SRF消退，第2组为55%（p=0.821）。随访时两组间VA无差异（p=0.637）。
结论
在维替泊芬短缺期间，采用了不同的治疗策略，HD-PDT的实施频率降低。通过采用更具个体化的方法，VA和SRF消退率与短缺前一年相似。
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