中药联合半剂量维替泊芬光动力疗法治疗慢性CSC的临床疗效观察

Clinical observation on treatment of chronic central serous chorioretinopathy with Chinese medicine combined with half-dose photodynamic therapy

目的观察中药联合半剂量维替泊芬光动力疗法(photodynamic therapy,PDT)治疗慢性中心性浆液性脉络膜视网膜病变(central serous chororetinopathy,CSC)的效果。方法对27例36眼慢性CSC患者,行半剂量维替泊芬PDT治疗,术后根据中医辨证施治原则配合中药汤剂治疗,随访6~12个月,以最佳矫正视力(best corrected visual acuity,BCVA)、视网膜下液隆起最高点高度(the height of highest point of subretinal fluid,HPSF)作为疗效指标,观察该法有效率及复发率。结果治疗后3个月、6个月及末次随访时BCVA提高,与治疗前相比差异有统计学意义。治疗后1个月内视网膜下液吸收明显。末次随访时,显效22眼(61.11%),有效11眼(30.56%),总有效率91.76%。随访过程中1眼复发,经再次中药联合半量PDT治疗后好转。随访期间36眼未见不良反应。结论中药联合半剂量维替泊芬光动力疗法治疗慢性CSC安全有效,有效降低复发率。

OBJECTIVE To observe the effect of Chinese medicine combined with photodynamic therapy （PDT） of half-dose verteporfin on chronic central serous chorioretinopathy （CSC）. METHODS Twenty-seven patients （36 eyes） with chronic CSC were treated with PDT of half-dose verteporfin in addition to Chinese medicine according to the principle of syndrome differentiation. The patients were followed up for 6 to 12 months. The best corrected visual acuity （BCVA） and the height ot the hlgllest point of suoreu- nal fluid （HPSF） were used to evaluate the efficacy and relapse rate of treatments. RESULTS The BCVA improved 3 months, 6 months after therapy as well as at the last follow-up which meant comparisons were of statistical differ- ences. Within the first month after treatment, subretinal fluid absorption was significant. At the end of follow-up, 22 eyes （61.11%） were significantly effective, 11 eyes （30.56%） were effective, the total effective rate was 91.76%. During the follow-up, one eye relapsed but improved after the followed treatment. There were no adverse reactions in 36 eyes during follow-up. CONCLUSIONS The method of Chinese medicine combined with photodynamic therapy of half- dose verteporfin was safe and effective in management of chronic CSC, and effectively reduced the recur- rence rate.