半剂量维替泊芬光动力疗法治疗慢性CSCR的回顾性研究

Retrospective study on half- dose verteporfin photodynamic therapy for treatment of chronic central serous chorioretinopathy

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.