Kiskämper Anna, Augstein Maximilian, von Schwarzkopf Christoph, Laich Yannik, Rothaus Kai, Janning Carolin, Pauleikhoff Laurenz, Lange Clemens
Augenzentrum am St. Franziskus-Hospital Münster, Hohenzollernring 74, 48145, Münster, Deutschland.
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Ophthalmologie. 2025 Aug 23. doi: 10.1007/s00347-025-02311-w.
Persistent central serous chorioretinopathy (CSC) is a complex macular disease that if left untreated can lead to deterioration of visual acuity and impairment of the quality of life. A treatment of choice is photodynamic therapy (PDT), which in studies has been shown to achieve stable functional and morphological results with a short follow-up period. As there are only few studies on the long-term evolution after PDT, this study aims to evaluate the long-term functional and morphological outcomes after PDT.
In this multicenter retrospective cohort analysis, patients with persistent CSC treated with PDT during 2004-2020 were analyzed over a follow-up period of at least 4 years after PDT. In addition to the clinical examination, the results of multimodal imaging techniques such as optical coherence tomography (OCT), OCT angiography, fundus autofluorescence and fluorescein angiography were analyzed.
A total of 33 eyes of 31 patients were analyzed over a mean follow-up period of 7.3 ± 3.6 years (4-19 years) after PDT. During the observation period a stable mean visual acuity of 0.41 ± 0.29 logMAR before PDT and 0.39 ± 0.38 logMAR at the last follow-up was observed. The subfoveal subretinal fluid (SRF) decreased significantly from a mean of 153 ± 90 µm (median 137 µm) before PDT to 24 ± 61 µm (median 0 µm) at the last follow-up. Of the 33 eyes 23 showed no evidence of SRF at the last OCT examination. Five eyes developed new choroidal neovascularization during the course of the study, which was treated with intravitreal injections. In a total of nine eyes newly occurring atrophy of the retinal pigment epithelium was detected at the last follow-up.
In the present study a predominantly stable functional and improved anatomical outcome after PDT was observed over a long observation period of more than 7 years. Further prospective long-term studies with a high level of evidence are required for a better assessment of the safety and functionality of PDT.
持续性中心性浆液性脉络膜视网膜病变（CSC）是一种复杂的黄斑疾病，若不治疗可导致视力下降及生活质量受损。光动力疗法（PDT）是一种治疗选择，研究表明其在短期随访中可取得稳定的功能和形态学效果。由于关于PDT后长期演变的研究较少，本研究旨在评估PDT后的长期功能和形态学结果。
在这项多中心回顾性队列分析中，对2004年至2020年期间接受PDT治疗的持续性CSC患者进行了至少4年的随访分析。除临床检查外，还分析了光学相干断层扫描（OCT）、OCT血管造影、眼底自发荧光和荧光素血管造影等多模态成像技术的结果。
共对31例患者的33只眼进行了分析，PDT后的平均随访期为7.3±3.6年（4至19年）。在观察期内，PDT前平均视力稳定在0.41±0.29 logMAR，末次随访时为0.39±0.38 logMAR。黄斑下视网膜下液（SRF）从PDT前的平均153±90 µm（中位数137 µm）显著降至末次随访时的24±61 µm（中位数0 µm）。33只眼中有23只在末次OCT检查时未发现SRF迹象。在研究过程中，5只眼出现了新的脉络膜新生血管，接受了玻璃体腔内注射治疗。在末次随访时，共9只眼检测到新出现的视网膜色素上皮萎缩。
在本研究中，在超过7年的长期观察期内，观察到PDT后主要为稳定的功能和改善的解剖学结果。需要进一步开展具有高证据水平的前瞻性长期研究，以更好地评估PDT的安全性和功能性。
