光动力疗法对中心性浆液性脉络膜视网膜病变的疗效

Effect of photodynamic therapy for central serous chorioretinopathy

目的评价半剂量维替泊芬（Verteporfin）光动力疗法对慢性中心性浆液性脉络膜视网膜病变的远期疗效。方法回顾性分析我院62例（65只眼）经半剂量维替泊芬光动力疗法治疗的慢性中心性浆液性脉络膜视网膜病变的病历资料。对比分析治疗前后最佳矫正视力（BCVA）、荧光素眼底血管造影、吲哚青绿血管造影、光学相干断层扫描的资料。结果平均随访（35．83±14．12）个月，末次随访时BCVA较治疗前提高，差异有统计学意义（t=7．491，P=0．000）。末次随访时视网膜中心凹厚度（CFT）较治疗前减少，差异有统计学意义（t=-19．293，P=0．000）。患者年龄与末次随访BCVA无显著相关性（r=0．019，P=0．883）。患者病程与末次随访BCVA显著相关（r=0．395，P=0．001）。患者基线视网膜中心凹厚度未发现与末次随访时BCVA有相关关系（r=0．055，P=0．665）。患者基线BCVA与末次随访BCVA显著相关（r=0．442，P=0．000）。患者末次随访视网膜中心凹厚度与末次随访时BCVA显著相关（r=0．364，P=0．003）。在随访中有6只眼复发，平均治疗次数为（1．11±0．36）次。随访过程中未发现任何并发症。结论半剂量维替泊芬光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变长期效果良好。

Objective To evaluate the long-term effect of photodynamic therapy （PDT）with half- dose Verteporfin for chronic central serous chorioretinopathy（CSC）. Methods A retrospective, case series analysis was conducted in 65 eyes of 62 patients with chronic CSC undergoing PDT using half dose of Verteporfin. Best-corrected visual acuity （BCVA）, results of fundus fluorescein angiography （FFA）, indocyanine green angiography （ ICGA ） and optic coherence tomograpby （ OCT ） were compared between before and after the treatment. Results The mean follow-up was （35.83±14.12） months. The difference between baseline BCVA and final BCVA was statistically significant （t = 7. 491, P = 0.000）. The difference between baseline central foveal thickness（CFF） and final CFT was statistically significant （t = - 19. 293, P = 0. 000）. The prolonged duration, baseline BCVA and final CFT was significantly correlated to the final BCVA （r=0.395,P=0.001; r=0.442,P=0. 000;r=0.364,P=0.003）. The patient＇s age and the baseline CFF were not significantly correlated to the final BCVA （ r = 0. 019, P = 0. 883 ; r = 0. 055, P = 0. 665 ）. The mean number of PDT treatment was 1.11±0.36. Six of 65 eyes recurred during the follow-up. None of the patients in the study developed any systemic adverse event. Conclusion PDT with half-dose Verteporfin has a good long-term efficacy for the treatment of chronic CSC.