慢性难治性中心性浆液性脉络膜视网膜病变的光动力疗效观察

Photodynamic Therapy in Chronic Intractable Central Serous Chorioretinopathy

目的观察光动力疗法对慢性难治性中心性浆液性脉络膜视网膜病变的疗效。方法回顾分析维速达尔治疗慢性难治性中心性浆液性脉络膜视网膜病变的临床资料,共计13例(17只眼),其中多个渗漏点9例(12只眼),一个渗漏点4例(5只眼)。观察术后1周,1个月,3个月及其6个月的最佳矫正视力,眼底荧光血管造影(FFA),光学相关断层扫描(OCT)。结果术后1周,FFA显示15只眼轻度的荧光渗漏,2只眼渗漏消失,OCT显示13只眼神经上皮下积液减少,4只眼神经上皮下少许积液。术后1个月,FFA显示7只眼荧光轻度渗漏着染,10只眼荧光渗漏消失,OCT显示7只眼少许神经上皮下积液,其余积液消失。3个月和6个月FFA显示15只眼荧光渗漏消失,2只眼荧光着染,OCT显示无荧光积存。6个月时,最佳矫正视力(BCVA)提高两行以上的有12只眼,占71%。结论光动力疗法对慢性难治性中心性浆液性脉络膜视网膜病变疗效显著。

Objective To evaluate the efficacy of photodynamic therapy（PDT） with verteporfin in the treatment of severe chronic central serous chorioretinopathy （CSC）. Methods The data of seventeen eyes （13 patients） with severe chronic CSC after PDT were studied retrospectively. Twelve eyes （9 patients） of all patients have several leaking spots, others have one. The effectiveness of the treatment was assessed with fundus fluorescence angiography （FFA）, optical coherence tomography （ OCT）, Best corrected visual acuity （BCVA） before operation and 1 week, 1 month, 3 months and 6 months later. Results Fluorescence leakage stopped at 1 week later in 2eyes（2/17）, at 1 month later in 10 eyes（10/17） ,at 3months and 6 months in 15 eyes（15/17） after treatment. Fruid reduction was demonstrated by OCT in 13 eyes（13/17） ,Four eyes have little fluid in subretinal by OCT. Seven eyes remained subretinal little fluid by OCT at 1 month. Complete absorbance of subretinal fluid could be demonstrated by OCT at 3 months and 6 months. BCVA of 12 eyes（ 12/17,71% ） were improved by two lines and more at 6 months. Conclusion PDT with verteporfin in the treatment of severe chronic CSC is effective.