光学相干断层扫描血管成像引导光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变  

Photodynamic therapy guided by optical coherence tomography angiography for treatment of chronic central serous chorioretinopathy

作　　者：邱新文[1] 任旋[1] 兰丽霞[1] 邱丘 叶波[1] QIU Xin-Wen;REN Xuan;LAN Li-Xia;QIU Qiu;YE Bo(Department of Fundus Diseases,Nanchang Aier Eye Hospital,Nanchang 330002,Jiangxi Province,China)

机构地区：[1]南昌爱尔眼科医院眼底病科

出　　处：《眼科新进展》2019年第8期767-771,共5页Recent Advances in Ophthalmology

基　　金：南昌市科技支撑计划项目(编号:2018-235-19)~~

摘　　要：目的探讨光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)作为一种新方法引导光动力疗法(photodynamic therapy,PDT)治疗慢性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的疗效。方法非随机病例对照研究。慢性CSC患者60例(60眼),按引导PDT光斑设计方法分为三组,每组各20例,A组由荧光素眼底血管造影设计、B组由吲哚菁绿血管造影设计、C组由OCTA设计,同时选入正常眼36例(36眼)作为对照;患者均采用半剂量维替泊芬PDT进行治疗。比较治疗前后不同时期最佳矫正视力(best corrected visual acuity,BCVA)、视网膜下液(subretinal fluid,SRF)吸收时间、光感受器内外节至Bruch膜厚度(photoreceptor inner/outer segment to bruch member thickness,IOBT)、中央视网膜厚度(central retinal thickness,CRT)、黄斑中心凹下脉络膜厚度(subretinal fovea choridial thickness,SFCT)、后极部6 mm×6 mm区域脉络膜毛细血管血流密度(choriocapillary layer angio-flow density,CFD)以及治疗后并发症情况。结果 PDT光斑大小A组(1500.00±79.47)μm、B组(2800.00±629.95)μm、C组(2700.00±553.46)μm差异有统计学意义(P=0.000),A组明显小于B、C组(均为P=0.000),B、C两组差异无统计学意义(P=0.358)。三组SRF吸收时间差异有统计学意义(P=0.000),其中A组比B、C组时间延长(均为P=0.000),B、C组差异无统计学意义(P=0.151)。SRF吸收后三组BCVA显著提高、IOBT显著增厚,差异均有统计学意义(均为P=0.000),三组间BCVA差异无统计学意义(P=0.176)、IOBT差异有统计学意义(P=0.041)。SRF吸收后三组CRT、SFCT与CFD明显降低,差异均有统计学意义(均为P=0.000),三组间CRT、CFD差异均有统计学意义(均为P=0.000),但SFCT差异无统计学意义(P=0.245)。CSC患者治疗前后BCVA、CRT、SFCT、IOBT以及治疗前CFD与正常眼差异均有统计学意义(均为P<0.05)。治疗后未见与视力相关的眼部及全身并发症。结论适当大Objective To explore the effect of optical coherence tomography angiography(OCTA) as a new technique to guide photodynamic therapy(PDT) in the treatment of chronic central serous chorioretinopathy(CSC).Methods A non-randomized case-control study.Sixty patients(60 eyes) with chronic CSC were divided into three groups according to the guiding PDT spot design method,20 patients in each group.Group A was designed by fluorescence angiography,group B was designed by indocyanine green angiography,and group C was designed by OCTA.At the same time,36 normal patients(36 eyes) were selected as the control group.All patients were treated by PDT with half-dose verteporfin.The best corrected visual acuity(BCVA),subretinal fluid(SRF) disappearance time,photoreceptor inner/outer segment to bruch member thickness(IOBT),central retinal thickness(CRT),subretinal fovea choridial thickness(SFCT),choriocapillary layer angi-flow density(CFD) on 6 mm×6 mm region of the posterior pole and postoperative complications were compared and analyzed before and after PDT treatment.Results There were significant differences between group A [(1500.00±79.47)μm],group B [(2800.00±629.95)μm],and group C [(2700.00±553.46)μm] in PDT treatment spot(P=0.000),the treatment spot of group A was significantly smaller than group B and group C(both P=0.000),and there was no significant difference between group B and group C(P=0.358).SRF absorption time of the three groups was significantly different(P=0.000),in which the time of group A was longer than that of group B and group C(both P=0.000),while the time of group B and group C was not significantly different(P=0.151).After SRF absorption,BCVA was significantly increased in the three groups(all P=0.000),IOBT was significantly increased and structure was improved(all P=0.000),there was no significant difference in BCVA(P=0.176) and was significantly different in IOBT between the three groups(P=0.041).After SRF absorption,CRT,SFCT and CFD were significantly reduced in the three groups(all P=0.000),and

关 键 词：荧光素眼底血管造影 吲哚菁绿血管造影 光学相干断层扫描血管成像 光动力疗法 中心性浆液性脉络膜视网膜病变 

分 类 号：R774.5[医药卫生—眼科]