半剂量维替泊芬与半能量光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变  

Half-dose verteporfin and half-fluence photodynamic therapy for chronic central serous chorioretinopathy

作　　者：马为梅[1] 雷晓琴[1] 田芳[1] 周荣乐[1] 

机构地区：[1]西安市第四医院眼科,陕西省西安市710004

出　　处：《眼科新进展》2017年第4期341-343,共3页Recent Advances in Ophthalmology

基　　金：陕西省科技厅社会发展科技攻关项目(编号:2015SF232;2015SF085;2015SF106);西安市科技局社会发展引导计划-医学研究项目[编号:SF1513(3)]~~

摘　　要：目的比较半剂量维替泊芬光动力与半能量光动力疗法(photodynamic therapy,PDT)对慢性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)治疗的有效性和安全性。方法回顾性队列病例研究。将我院门诊确诊为慢性CSC患者42例(42眼)纳入研究。根据患者PDT治疗过程中所接受的药物剂量和激光参数的不同分为半剂量和半能量组。半剂量组22例(22眼)接受半剂量维替泊芬(3 mg·m^(-2))和标准能量PDT(83 s,50 J·cm^(-2))治疗。半能量组20例(20眼)接受全剂量维替泊芬(6 mg·m^(-2))和半能量PDT(42 s,25 J·cm^(-2))治疗。PDT治疗后1、3、6个月随访,观察两组患者视网膜下液(subretinal fluid,SRF)完全吸收的比例,最佳矫正视力(best corrected visual acuity,BCVA)变化和黄斑部视网膜厚度(central macular thickness,CMT)的变化。结果治疗后6个月,半剂量组患者22眼(100%)SRF完全吸收,半能量患者19例(95%)SRF完全吸收,两组间治愈率比较差异无统计学意义(P>0.05);治疗后6个月,半剂量组BCVA提高7.2字母,半能量组BCVA提高6.7个字母,BCVA提高字母数两组间比较差异无统计学意义(P>0.05)。治疗前半剂量组CMT为(351±90)μm,治疗后6个月降至(178±55)μm,治疗前后比较差异有统计学意义(P<0.05),半能量组CMT治疗前为(322±96)μm,治疗后6个月降至(181±47)μm,治疗前后比较差异有统计学意义(P<0.05)。所有患者均未出现视网膜色素上皮萎缩、脉络膜新生血管形成等并发症。结论半剂量维替泊芬光动力和PDT治疗慢性CSC同样安全有效。Objective To compare the efficacy and safety of half-dose verteporfin and half-fluence photodynamic therapy in chronic central serous chorioretinopathy （CSC）.Methods The medical records of 42 patients（42 eyes） with chronic CSC were retrospectively reviewed.According to the difference of drug dose and laser parameters in the course of PDT,the patients were divided into two groups：half-dose group and half-fluence group.Half-dose group：22 patients （22 eyes）received half-dose verteporfin（3 mg·m-2）and standard PDT（83 s,50 J·cm-2）.Half-fluence group：20 patients （20 eyes）received full-dose verteporfin（6 mg·m-2）and half-fluence PDT （42 s,25 J·cm-2）.Patients were followed up at 1 month,3 months,6 months after PDT.The outcome measures was the proportion of eyes with complete resolution of subretinal fluid（SRF）,the changes in best corrected visual acuity （BCVA） and central retinal thickness（CMT）.Results At 6 months after PDT,22 eyes（100%） that received half-dose PDT showed complete resolution of SRF,19 eyes（95%）that received half-fulence PDT showed complete resolution of SRF.There was no statistical difference between two groups （P〉0.05）.At 6 months after PDT,the mean BCVA improved 7.2 letters in half-dose group and 6.7 letters in half-fluence group.There was no statistical difference compared with the improvement of BCVA between two groups（P〉0.05）.In half-dose group,mean baseline central retinal thickness was （351±90）μm,which was decreased to （178±55）μm after 6 months,respectively （P〈0.05）.In half-fluence group,mean baseline central retinal thickness was （322±96）μm,which was decreased to （181±47）μm after 6 months,respectively （P〈0.05）.None of the patients developed retinal pigment epithelium atrophy and CNV.Conclusion Half-dose verteporfin PDT and half-fluence PDT are effective and safe in the treatment of chronic CSC.

关 键 词：光动力学疗法 慢性中心性浆液性脉络膜视网膜病变 维替泊芬 

分 类 号：R774[医药卫生—眼科]