光相干断层扫描增强深部成像观察半剂量光动力疗法治疗急性中心性浆液性脉络膜视网膜病变的疗效  

The efficacy of half-dose photodynamic therapy for acute central serous chorioretinopathy by enhanced deep imaging of optical coherence tomography

作　　者：张彩云 毛剑波 沈丽君 邵伊润 林晶晶 劳吉梦 郑子成 刘伯温 Zhang Caiyun;Mao Jianbo;Shen Lijun;Shao Yirun;Lin Jingjing;Lao Jimeng;Zheng Zicheng;Liu Bowen(Eye Hospital Wenzhou Medical University,Hangzhou 310000,China)

机构地区：[1]温州医科大学附属眼视光医院杭州院区,310000

出　　处：《中华眼底病杂志》2020年第9期702-706,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：温州市基础性医疗卫生科技项目(Y20180728、Y20190635、2019Y0592)。

摘　　要：目的应用光相干断层扫描增强深部成像(EDI-OCT)观察半剂量光动力疗法(PDT)治疗急性中心性浆液性脉络膜视网膜病变(CSC)的临床疗效。方法回顾性病例研究。2015年9月至2018年11月在温州医科大学附属眼视光医院杭州院区接受半剂量PDT治疗的急性CSC患者100例100只眼纳入研究。其中,男性69例,女性31例;平均年龄(49.63±7.97)岁;平均病程(2.19±0.71)个月。所有患者均行BCVA、EDI-OCT、FFA、ICGA等检查。BCVA检查采用国际标准视力表进行,并换算为logMAR视力记录。患眼治疗前平均logMAR BCVA为0.29±0.19,平均黄斑中心凹视网膜厚度(CMT)为(370.59±134.98)μm,平均黄斑中心凹下脉络膜厚度(SFCT)为(366.93±86.95)μm。所有患者均行半剂量PDT治疗。对比观察患眼治疗前及治疗后2周和1、3、6个月的BCVA、CMT、SFCT、视网膜下积液(SRF)变化情况。采用Pearson相关分析法分析治疗6个月后BCVA与基线BCVA、CMT、SFCT之间的相关性。结果治疗后6个月,98只眼SRF完全吸收,有效率98.0%。与治疗前比较,治疗后2周和1、3、6个月,患眼BCVA明显提高(F=66.493,P<0.001),CMT和SFCT明显降低(F=134.625、30.394,P<0.001、<0.001)。Pearson相关性分析结果显示,治疗后6个月BCVA与基线BCVA呈正相关(r=0.529,P<0.001),与CMT、SFCT无明显相关性。所有患者随访期间均未出现与治疗相关的严重并发症。结论半剂量PDT治疗急性CSC短期内能有效提高患眼BCVA,EDI-OCT可观察到患眼治疗后CMT、SFCT明显降低,SRF吸收。Objective To observe the clinical efficacy of half-dose photodynamic therapy(PDT)in the treatment of acute central serous chorioretinopathy(CSC)by enhanced deep imaging-OCT(EDI-OCT).Methods A retrospective case study.From September 2015 to November 2018,100 patients with acute CSC who received half-dose PDT in Hangzhou Branch of the Eye Optometry Hospital of Wenzhou Medical University were included in the study.Among 100 patients,69 patients were males and 31 patients were females;the average age was 49.63±7.97 years;the average duration of disease was 2.19±0.71 months.All patients underwent BCVA,EDI-OCT,FFA,ICGA and other examinations.BCVA was used on the international standard visual acuity chart and converted to logMAR visual acuity records.Before treatment,the average logMAR BCVA was 0.29±0.19,the average macular foveal retinal thickness(CMT)was 370.59±134.98μm,and the average macular subfoveal choroidal thickness(SFCT)was 366.93±86.95μm.All patients were treated with half-dose PDT.We compared the changes of BCVA,CMT,SFCT,and subretinal fluid(SRF)of the eye before treatment and 2 weeks after treatment and 1,3,and 6 months.Pearson correlation analysis method was used to analyze the correlation between BCVA and baseline BCVA,CMT,SFCT after 6 months of treatment.Results Six months after treatment,SRF was completely absorbed in 98 eyes,with an effective rate of 98.0%.Compared with before treatment,2 weeks and 1,3,and 6 months after treatment,the BCVA of the eye significantly increased(F=66.493,P<0.001),and CMT and SFCT significantly decreased(F=134.625,30.394;P<0.001,<0.001).The results of Pearson correlation analysis showed that BCVA was positively correlated with baseline BCVA 6 months after treatment(r=0.529,P<0.001),and there was no significant correlation with CMT and SFCT.There were no serious complications related to treatment during the follow-up period.Conclusions Half-dose PDT can effectively increase BCVA in a short period of time for acute CSC.EDI-OCT can observe that CMT,SFCT and SRF absorptio

关 键 词：中心性浆液性脉络膜视网膜病变/治疗 光化学疗法 体层摄影术 光学相干 

分 类 号：R774.1[医药卫生—眼科]