半量PDT治疗中心性浆液性脉络膜视网膜病变疗效与黄斑区结构变化的短期临床观察  

Clinical observation of the efficacy of half-volume PDT in the treatment of central serous chorioretinopathy and structural changes in the macular area

作　　者：郑建龙[1] 张安琳[1] 陈适蓉 周玲玲[1] ZHENG Jianlong;ZHANG Anlin;CHEN Shirong(Shantou University-Chinese University of Hong Kong Joint Shantou International Eye Center,Guandong Shantou 5150419,China)

机构地区：[1]汕头大学-香港中文大学联合汕头国际眼科中心

出　　处：《江西医药》2019年第12期1485-1487,1514,共4页Jiangxi Medical Journal

基　　金：广东省医学科学技术研究基金项目，编号A2016567

摘　　要：目的观察半剂量维替泊芬光动力(PDT)治疗中心性浆液性脉络膜视网膜病变(CSC)的短期疗效与黄斑区结构变化特点。方法回顾性分析2016年8月至2018年9月在我院确诊为CSC患者34例(35眼)作为观察组,病程:3-44个月,均采用半剂量维替泊芬联合标准能量PDT治疗一次且治愈,术后1个月(m)复查,同时将正常视力(裸眼≥1.0)19例(21眼)黄斑区结构数据作为对照组,观察CSC患者半量PDT治疗前和治疗后1mon的最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)、黄斑中心凹神经上皮层厚度(CNT)、外核层厚度(ONT)、椭圆体带(EZ)和嵌合体区(IZ)的结构变化,以及与正常视力组的差异;分析BCVA与CNT、EZ、IZ的相关性。结果35眼CSC患者治疗前logMAR BCVA 0.24±0.17,治疗后1m的logMAR BCVA 0.12±0.16,治疗前后BCVA差异具有统计学意义(P<0.001),除正常视力组与PDT治疗后1m组CNT比较无显著统计学差异,其余正常视力组、治疗前组、治疗后1m组之间的CMT、CNT、ONT均有统计学差异(均P<0.05),治疗后1个月32眼(91.4%)视网膜下积液(SRF)完全吸收,治疗3个月时提升到35眼(100%)完全吸收SRF,治疗前较治疗后1m组IZ解剖结构具有显著性差异。结论短期内观察半量PDT可安全、有效、快速、改善CSC患者视力,促进SRF的吸收,视力的改善与CNT和EZ、IZ的结构恢复相关。Objective To observe the short-term efficacy and structural changes of macular area in half-dose Vetiporfin photodynamic therapy(PDT)for central serous choroidal retinopathy(CSC).Methods A retrospective analysis of 34 patients(35 eyes)diagnosed with CSC in our hospital from August 2016 to September 2018 was selected as the observation group.The course of disease:3 to 44 months,all using half-dose Vetiporfin combined with standard energy PDT was treated once and cured,and one month(m)post-examination was performed.At the same time,the macular structure data of 19 cases(21 eyes)with normal vision(nude eye≥1.0)was used as a control group,and half of patients with CSC before and 1 month after treatment were observed.Best corrected visual acuity(BCVA),macular foveal retinal thickness(CMT),macular foveal neuroepithelial layer thickness(CNT),outer nuclear layer thickness(ONT),ellipsoidal band(EZ),and chimeric region(IZ)Structural changes and differences from the normal vision group;analysis of the correlation between BCVA and CNT,EZ,IZ.Results 35 eyes of CSC patients had logMAR BCVA before treatment and logMAR BCVA at 1m after treatment,the difference in BCVA before and after treatment was statistically significant(P<0.001).Except for normal vision group and 1m group CNT after PDT treatment.There was no statistically significant difference.The CMT,CNT,and ONT of the other normal vision groups,the pre-treatment group,and the 1m group after treatment were statistically different(all P<0.05),32 eyes(91.4%)at 1 month after treatment.Subretinal effusion(SRF)was completely absorbed,and it was elevated to 35 eyes(100%)to completely absorb SRF at 3 months of treatment.There was a significant difference in the anatomy structure of IZ before treatment compared with 1m after treatment.Conclusion Short-term observation of half-volume PDT can safely,effectively,and quickly improve the vision of CSC patients and promote the absorption of SRF.The improvement of vision is related to the structural recovery of CNT,EZ,and IZ.

关 键 词：半量光动力 维替泊芬 慢性中心性浆液性脉络膜视网膜病变 最佳矫正视力 外核层厚度 

分 类 号：R774.1[医药卫生—眼科]