慢性中心性浆液性脉络膜视网膜病变半剂量光动力治疗前后脉络膜厚度的改变

Changes of Choroidal Thickness After Half-Dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

目的:应用频域光学相干断层扫描加强深度成像(EDI-OCT)技术定量分析慢性中心性浆液性脉络膜视网膜病变(CSC)患者光动力(PDT)治疗前后脉络膜厚度变化趋势。方法:在不散瞳条件下,使用CirrusTM HD OCT采用EDI技术,以长度6mm五线高清单线扫描模式对25例(37眼)进行后极部行水平及垂直方向扫描,获取黄斑区断层图像。定义视网膜色素上皮层外界至巩膜内界之间的垂直距离为脉络膜厚度。所有患者在PDT前,PDT治疗后半个月、1个月、3个月测量中心凹下及0°、90°、180°及270°处距离中心凹1.5mm处多位点脉络膜厚度,并分析PDT治疗前与治疗后半个月、治疗后半个月与治疗后1个月、治疗后1个月与治疗后3个月不同时间点脉络膜厚度的变化幅度。结果:所有患眼治疗前中心凹下脉络膜厚度为310-653μm,均值为(470.65±97.38)μm,术后半个月、1个月及3个月中心凹下脉络膜厚度均值分别为(435.81±76.47)μm、(351.68±85.08)μm、(310.81±66.85)μm,较治疗前均明显下降,具有显著的统计学意义;且光动力治疗后1月内脉络膜厚度减小幅度最大。0°、90°、180°及270°位点脉络膜厚度变化趋势与中心凹下脉络膜厚度变化趋势类似。结论:PDT治疗后,短期内慢性CSC患者脉络膜厚度呈下降趋势,且1个月内脉络膜厚度下降最为明显。

Objective： To observe the change of choroidal thickness with enhanced depth imaging OCT. Methods： Twenty-five chronic central serous chorioretinopathy CSC,thirty-seven eyes underwent geiss Cirrus SD-OCT （5 HD Line） without mydriasis. The central fovea at 0° and 90° was scanned by 6 mm long scan lines and choroidal thickness was measured before half-dose photodynamic therapy （PDT）, 2 weeks, 1 month and 8 months after half-dose PDT with EDI-OCT imaging at subfoveal and 1.5 mm far away from central foveal on position of 0 °, 90 °, 180°, and 270°. The choroidal thickness was measured manually by using calipers to measure the distance from the outer border of the RPE to the inner surface of the sclera. Results： The choroidal thickness was 310-653 μm and the average subfoveal choroidal thickness （Sfct） was （470.65±97.38）μm. TheSfct were （435.81±76.47） μm, （351.68±85.08） μm, and （310.81±66.85） btmafter 2 weeks, 1 month, and 3 months, and were significantly lower than that before treatment. Meanwhile, the choroidal thickness of other positions had the similar changes to Sfct. Conclusion： The choroidal thickness of chronic CSC is decreasing in short term especially in 1 month after PDT.