Dubar Paul, Mathis Thibaud, Hucteau Emilie, Thariat Juliette, Nhari Maxime, Maschi Célia, Faber Carsten, Kiilgaard Jens Folke, Mosci Carlo, Favard Catherine, Tick Sarah, Nguyen Anh-Minh, Caujolle Jean-Pierre, Delyfer Marie-Noëlle, Rosier Laurence
Department of Ophthalmology, University Hospital of Bordeaux, Bordeaux, France.
Department of Ophthalmology, University Hospital Croix-Rousse, Lyon, France.
Acta Ophthalmol. 2025 May 5. doi: 10.1111/aos.17513.
The aim of the study is to compare the risk of first-line photodynamic therapy (PDT) failure according to the PDT protocol performed in patients with exudative choroidal circumscribed hemangioma (CCH).
We retrospectively included patients from 11 European centres in France, Italy and Denmark. Two groups were established: patients treated with Standard Protocol PDT (SP-PDT) and patients treated with a 'Fast' Protocol PDT (FP-PDT), characterised by laser irradiation without delay after the end of the verteporfin infusion (8 min after start of infusion). We analysed groups on the risk of exudative CCH recurrence requiring a second line of treatment, defining the first-line PDT failure.
A total of 111 patients were included in the study: 76 treated with the SP-PDT and 35 with the FP-PDT. First-line PDT failure was observed for 45 patients (59%) in the SP-PDT group and 9 patients (26%) in the FP-PDT group, with a median follow-up of 3.5 [1.7-6.7] years and 2.3 [0.8-3.9] years, respectively. Final best-corrected visual acuity (BCVA) improvement did not differ between groups (p = 0.49). A multivariate survival analysis including initial CCH thickness and initial BCVA was performed over a two-year follow-up period: FP-PDT as first-line treatment was significantly associated with a lower risk of PDT failure [HR = 0.27, 95%CI (0.11-0.65)].
FP-PDT shows encouraging results in the treatment of CCHs, as it is associated with a lower risk of PDT failure. It may therefore represent an interesting avenue for optimised PDT parameters, although these results need to be confirmed by randomised trials.
本研究旨在比较渗出性脉络膜局限性血管瘤（CCH）患者根据不同光动力疗法（PDT）方案进行一线治疗失败的风险。
我们回顾性纳入了来自法国、意大利和丹麦11个欧洲中心的患者。分为两组：接受标准方案PDT（SP-PDT）治疗的患者和接受“快速”方案PDT（FP-PDT）治疗的患者，后者的特点是在维替泊芬输注结束后无延迟地进行激光照射（输注开始后8分钟）。我们分析了两组中需要二线治疗的渗出性CCH复发风险，将其定义为一线PDT治疗失败。
本研究共纳入111例患者：76例接受SP-PDT治疗，35例接受FP-PDT治疗。SP-PDT组45例患者（59%）出现一线PDT治疗失败，FP-PDT组9例患者（26%）出现一线PDT治疗失败，中位随访时间分别为3.5 [1.7 - 6.7]年和2.3 [0.8 - 3.9]年。两组最终最佳矫正视力（BCVA）改善情况无差异（p = 0.49）。在两年的随访期内进行了包括初始CCH厚度和初始BCVA的多因素生存分析：FP-PDT作为一线治疗与较低的PDT治疗失败风险显著相关[风险比（HR）= 0.27，95%置信区间（CI）（0.11 - 0.65）]。
FP-PDT在CCH治疗中显示出令人鼓舞的结果，因为它与较低的PDT治疗失败风险相关。因此，尽管这些结果需要通过随机试验来证实，但它可能是优化PDT参数的一个有意义的途径。
