半剂量维替泊芬光动力疗法治疗慢性CSCR的回顾性研究

摘要

目的：探讨半剂量维替泊芬光动力疗法( photodynamic therapy,PDT)对慢性中心性浆液性脉络膜视网膜病变( central serous chororetinopathy,CSCR)的治疗效果。　　方法：病例回顾研究。选择14例19眼已确诊的CSCR患者,所有患者均行 Snellen 视力表最佳矫正视力( best corrected visual acuity,BCVA)、直接检眼镜眼底检查、荧光素眼底血管造影( fundus fluorescein angiography,FFA)和光相干断层扫描( optical coherence tomography, OCT )检查。病程6~12mo,进行半剂量维替泊芬PDT治疗。治疗后随访6~12mo,观察患者病变区结构和功能改变。对患者治疗前后BCVA和黄斑中心凹区视网膜厚度( central foveal thickness,CFT)进行比较,采用配对t检验。　　结果：患者14例19眼经PDT治疗后末次随访时BCVA为0.57±0.08,与治疗前BCVA比较,差异有显著统计学意义( t=2.110, P<0.01)。末次随访时的BCVA与治疗前相比,19眼中有17眼(89.5%)视力改善,2眼(10.5%)视力不变。患者治疗后末次随访时 CFT 为228.44±56.88μm,与治疗前(368.67±32.18μm)比较,差异有显著统计学意义(t=2.110,P<0.01)。末次随访时OCT检查显示视网膜下液完全吸收17眼(89.5%),部分吸收者2眼(10.5%),随访期间病变无复发。　　结论：半剂量维替泊芬光动力疗法对慢性CSCR患者的治疗安全有效。%AIM: To observe the clinical effect of half - dose verteporfin photodynamic therapy ( PDT) in the treatment of chronic central serous chorioretinopathy ( CSCR) . METHODS: It was a retrospective case series analysis. Nineteen eyes of 14 patients with CSCR diagnosed by best corrected visual acuity (BCVA), direct ophthalmoscope, fundus fluorescein angiography ( FFA ) and optical coherence tomography ( OCT) were enrolled. The course of the disease was ranged 6~12mo, PDT was applied with half- dose verteporfin ( 3mg/m2 ). The patients were observed to determine the anatomic and functional outcomes during 6~12mo of the follow-up. Comparisons of pre- and post-treatment BCVA and central foveal thickness ( CFT) were performed using a paired t test. RESULTS: At the last follow-up visit, the mean BCVA was 0. 57±0. 08, there was statistical difference compared with that before PDT (t=2. 110; P<0. 01). Seventeen eyes (89. 5%) had improved vision, and 2 eyes (10. 5%) had stable vision. The mean CFT was reduced from 368. 67±32. 18μm to 228. 44±56. 88μm with statistical significance (t=2. 110; P < 0. 01 ). The results of OCT showed that subretinal fluid completely disappeared in 17 eyes (89.5%), partly absorbed in 2 eyes ( 10. 5%) after treatment. There was no recurrence during the follow-up.CONCLUSION:Half-dose of verteporfin PDT is effective and safe for the treatment of chronic or recurrent CSCR.