Jun Jae Won, Jeon Soyoung, Park Goeun, Kang Hyun Goo, Lee Christopher Seungkyu, Kim Min, Kim Sung Soo, Byeon Suk Ho, Lee Junwon
Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2025 Oct;66(10):666-674. doi: 10.3349/ymj.2024.0220.
To evaluate the treatment response and long-term prognosis of foveal serous retinal detachment (SRD) associated with inferior staphyloma to anti-vascular endothelial growth factor (anti-VEGF) treatment and photodynamic therapy (PDT).
Treatment-naïve patients who underwent >24 months of follow-up were included. We analyzed inter-visit changes in the foveal subretinal fluid (SRF) height after anti-VEGF treatment or PDT compared to no treatment and long-term prognosis of best-corrected visual acuity in choroidal neovascularization (CNV)-free patients.
Nineteen patients were enrolled, and the mean follow-up duration was 4.81 years. In 14 CNV-free patients, 11 received anti-VEGF injections, three patients underwent PDT, and two patients had both treatments. During the follow-up period, there were a total of 243 inter-visit events (88 injections and 155 observations without treatment). At the last visit of patients who received the treatment, complete resolution was more significantly achieved in the CNV group than in the CNV-free group (=0.028). In CNV-free patients, visual acuity improved when complete resolution was achieved; otherwise, it generally decreased. After adjusting for confounding factors, analyses showed no statistically significant differences in inter-visit changes of foveal SRF height between the anti-VEGF treatment and no treatment cases (absolute value, rate, subgroup categorized as ±20% of change; =0.733, =0.916, =0.277; respectively). All patients who underwent PDT did not show complete resolution or maintained improvement of SRF.
Treatment with anti-VEGF and PDT do not seem to be effective for foveal SRD of CNV-free inferior staphyloma.
评估与下方葡萄肿相关的黄斑部浆液性视网膜脱离（SRD）对抗血管内皮生长因子（抗VEGF）治疗和光动力疗法（PDT）的治疗反应及长期预后。
纳入未接受过治疗且随访时间超过24个月的患者。我们分析了抗VEGF治疗或PDT后与未治疗相比黄斑下视网膜积液（SRF）高度的访间变化，以及无脉络膜新生血管（CNV）患者最佳矫正视力的长期预后。
共纳入19例患者，平均随访时间为4.81年。在14例无CNV的患者中，11例接受了抗VEGF注射，3例患者接受了PDT，2例患者接受了两种治疗。在随访期间，共有243次访间事件（88次注射和155次未治疗观察）。在接受治疗的患者最后一次随访时，CNV组比无CNV组更显著地实现了完全消退（P=0.028）。在无CNV的患者中，当实现完全消退时视力改善；否则，视力通常下降。在调整混杂因素后，分析显示抗VEGF治疗组与未治疗组之间黄斑SRF高度的访间变化无统计学显著差异（绝对值、变化率、分类为变化±20%的亚组；P分别为0.733、0.916、0.277）。所有接受PDT的患者均未显示完全消退或SRF持续改善。
抗VEGF和PDT治疗似乎对无CNV的下方葡萄肿黄斑部SRD无效。
