半剂量光动力治疗中心性浆液性脉络膜视网膜病变

Photodynamic Therapy with Half Dose Verteporfin for Chronic Central Serous Chorioretinopathy

目的观察半剂量维替泊芬光动力治疗中心性浆液性脉络膜视网膜病变(中浆)的临床疗效及安全性。方法对已确诊的慢性中浆共5例(8眼)行单次维替泊芬光动力治疗,药物剂量为每平方米体表面积3 mg,光照剂量50 J/cm^2,根据吲哚青绿血管造影(indocyanine green angiography,ICGA)确定治疗光斑,分析治疗前、后眼底荧光血管造影(fundus fluorescein angiography,FFA)和 ICGA 的结果及并发症。结果术后1个月,FFA 显示6眼渗漏完全消失,2眼渗漏减轻;ICGA见8眼脉络膜血管扩张改善,4眼渗漏消失,4眼渗漏减轻。术后3个月,FFA 显示8眼渗漏完全消失;ICGA 见8眼脉络膜血管扩张改善,5眼渗漏消失,3眼渗漏减轻;至末次随访未见复发及相关并发症。结论在 ICGA 指导下的半剂量维替泊芬光动力治疗可改善脉络膜微循环,缩短病程,安全有效地治疗慢性中浆,减少复发。(中国眼耳鼻喉科杂志,2007,7:362-363)

Purpose To evaluate the efficacy and safety of photodynamic therapy （PDT） with half dose verteporfin for chronic central serous chorioretinopathy （CSC）. Methods Eight eyes of 5 patients with chronic CSC received one single session of PDT with verteporfin（3 mg/m^2 body surface area） , followed by the application of laser with an energy density of 50 J/cm^2. The laser spot size was determined by the findings in indocyanine green angiography （ ICGA ）. The possible complications and the results of fundus fluorescein angiography（FFA） and ICGA were analyzed. Results In one month after the operation, fluorescence leakage stopped in 6 eyes and decreased in 2 eyes; ICGA revealed that the narrowing of the original dilated choroidal vessels improved in all 8 eyes, the leakage disappered in 4 eyes and decreased in 4 eyes. In 3 months after the operation, fluorescence leakage stopped in all 8 eyes; ICGA revealed that the nanrowing of the original dilated choroidal vessels improved in all 8 eyes, the leakage disappeared in 5 eyes and decreased in 3 eyes. Until the last follow-up, there were no recurrence and serious ocular or systemic complications. Condusions ICGA- guided PDT with half dose verteporfin might be an effective and safety treatment for CSC by improving the choroidal circulation,shortening the course of disease and reducing the recurrence.