螺内酯联合30%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

Efficacy of 30% Verteporfin Photodynamic Therapy Combined with Spironolactone on Chronic Central Serous Choroidal Retinopathy

目的比较螺内酯联合30%剂量维替泊芬与50%剂量维替泊芬光动力疗法(PDT)治疗慢性中心性浆液性脉络膜视网膜病变(CSC)的疗效。方法慢性CSC患者27例,随机分为治疗组13例15只眼,口服螺内酯联合30%剂量维替泊芬PDT治疗,对照组14例17只眼予以50%剂量维替泊芬PDT治疗。在维替泊芬PDT治疗后约2个月和6个月做眼部光学相干断层成像(OCT)和最佳矫正视力(BCVA)复查,两组间对应时间点做BCVA,中央黄斑区视网膜厚度(CMT),黄斑中心凹下脉络膜厚度(SFCT),视网膜下液吸收率(SRF)及复发率等统计学比较。结果两组在各时间点BCVA、CMT、SFCT以及SRF吸收和复发率比较均差异无统计学意义(P>0.05)。治疗组和对照组视网膜下液吸收分别为12和15只。在治疗后6个月两组患者BCVA、CMT和SFCT分别与基线比较均差异有统计学意义(均P<0.01)。其中治疗组BCVA变化较对照组更大,视力提升更快。结论螺内酯联合30%剂量维替泊芬PDT与50%剂量维替泊芬PDT治疗慢性CSC具有相似的良好疗效。

Objective To compare with efficacy of 30%verteporfin photodynamic therapy(PDT)combined with spironolactone vs.the half dose verteporfin PDT on chronic central serous retinopathy(CSC).Methods A total of 27 cases of chronic CSC were randomly divided into two groups:treatment group,13 cases with 15 eyes treated by oral spironolactone combined with 30%verteporfin PDT;control group,14 patients with 17 eyes treated by 50%verteporfin PDT.In about 2 months and 6 months after PDT treatment,eyes were detected by optical coherence tomography(OCT)imaging and best corrected visual acuity(BCVA)was determined.Statistical comparison was performed in BCVA,central macular thickness(CMT),subfoveal choroidal thickness(SFCT),subretinal fluid(SRF)absorptionand the recurrence rate between the two groups at the corresponding time point.Results The comparison of BCVA,CMT,SFCT and SRF absorption and recurrence rates at all time points between the two groups showed no statistically significant differences(P>0.05).The subretinal fluid absorption in treatment group and control group were 12 eyes and 15 eyes,respectively.The difference was statistically significant(P<0.01)when BCVA,CMT and SFCT were compared with baseline 6 months after treatment in each group.The changes of BCVA in treatment group were greater than those in control group,indicating faster visual improvement.Conclusion Spironolactone combined with 30%vitipofen photodynamic therapy and half dose verteporfin photodynamic therapy for chronic CSC has similar good effect