背景:中心性浆液性脉络膜视网膜病变(CSC)的特征是局灶性浆液性视网膜脱离,主要影响黄斑。光动力疗法(PDT)是治疗慢性和复发性患者的最佳选择。在这项研究中,我们旨在评估PDT激光治疗半剂量方案(3mg/m2维托波芬)对脉络膜微脉管系统的早期影响。
方法:在31例患者(62眼)中,对照组20只眼,42只眼接受PDT激光治疗.视觉日志MAR,CMT(中央黄斑厚度),SRF(视网膜下液),BCT(基线脉络膜厚度),CVI(脉络膜血管指数),比较两组激光治疗面积。
结果:结果表明,在中央凹的第一周,激光治疗的影响与SRF的分辨率之间没有检测到强相关性。患者的平均最佳矫正视力(BCVA)从研究开始时的20/63显着增加,根据Snellen的图表,20/49在第一周和20/38在第六周。与对照组相比,PDT可在6周内显着降低SRF和CMT。虽然最初有一个小的,1周后脉络膜厚度和CVI无统计学意义的增加,6周后出现急剧减少。因此,PDT激光6周后,所有指标,如SRF,CMT,脉络膜厚度,CVI显著降低。
结论:PDT激光可显著降低慢性CSC患者1周和6周时的SRF和CMT,6周时的脉络膜厚度和CVI。此外,较大的激光治疗面积对最终结果没有影响。因此,PDT在CSC疾病中的作用机制似乎是脉络膜毛细血管循环的恢复。
BACKGROUND: Central serous chorioretinopathy (
CSC) is characterized by focal serous detachment of the retina, primarily affecting the macula. Photodynamic therapy (PDT) is the best choice for treatment of chronic and recurrent patients. In this study we aim to evaluate the early effects of the half dose protocol (3 mg/m2 verteporfine) of PDT laser treatment on the micro vasculature of choroid.
METHODS: Among thirty-one patients (62 eyes), twenty eyes were in the control group and forty-two eyes received PDT laser treatment. Vision log MAR, CMT (central macular thickness), SRF (sub retinal fluid), BCT (baseline choroidal thickness), CVI (choroidal vascular index), and laser treated area were compared between two groups.
RESULTS: Results show that no strong correlation was detected between the impact of laser treatment and resolution of SRF in the first week in the fovea. The mean best corrected visual acuity (BCVA) of the patients significantly increased from 20/63 at the beginning of the study, according to the Snellen chart, to 20/49 in the first week and 20/38 in the sixth week. PDT can significantly reduce SRF and CMT in 6 weeks compared to the control group. Although there was initially a small, non-statistically significant increase in choroidal thickness and CVI after 1 week, a dramatic decrease occurs after 6 weeks. Therefore, after 6 weeks of PDT laser, all the indicators such as SRF, CMT, choroidal thickness, and CVI significantly reduced.
CONCLUSIONS: PDT laser can significantly reduce SRF and CMT at 1 and 6 weeks and choroidal thickness and CVI at 6 weeks in chronic
CSC patients. Also, a larger laser treated area has no impact on the final outcome. Therefore, it seems that the mechanism of PDT in
CSC disease is the recovery of choriocapillaris circulation.