Practical treatment options for persistent central serous chorioretinopathy and early visual and anatomical outcomes
Practical treatment options for persistent central serous chorioretinopathy and early visual and anatomical outcomes
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持续性中心性浆液性脉络膜视网膜病变的实用治疗选择以及早期视觉和解剖结果
DOI：
10.1007/s10384-023-00978-9
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发表时间：
2023
影响因子：
2.4
通讯作者：
Honda Shigeru
中科院分区：
文献类型：
--
作者：
Yamada-Okahara Naoko;Kyo Akika;Hirayama Kumiko;Yamamoto Manabu;Kohno Takeya;Honda Shigeru
目的持续性中心性浆液性脉络膜视网膜病变(PCSC)可采用激光光凝(PC)、选择性视网膜疗法(SRT)或光动力疗法(PDT)治疗。我们对PCSC在最佳临床实践中的治疗选择和这些模式的结果进行了回顾性分析。研究设计：回顾性干预研究。首先，评估基线临床参数以寻找与治疗方案选择相关的重要因素。结果PC组7只眼，SRT组22只眼，PDT组42只眼。荧光素血管造影术(FA)的渗漏模式与治疗的选择显著相关(p<；0.005)。治疗3个月后，PC组、SRT组和PDT组的干性黄斑发生率分别为29%、59%和81%，组间差异有统计学意义(P<；0.01)。所有组的最佳矫正视力在治疗后均有改善趋势。各组中心脉络膜厚度均显著降低(PC组、SRT组和PDT组分别为P<；0.05、P<；0.01和P<；0.00001)。对干性黄斑进行Logistic回归分析，发现SRT(p<；0.05)、PDT(p<；0.05)和CCT改变(p<；0.01)是干性黄斑渗漏的显著相关因素。治疗3个月后，PDT的干性黄斑比率明显高于PC。
PurposePersistent central serous chorioretinopathy (pCSC) may be treated by laser photocoagulation (PC), selective retina therapy (SRT), or photodynamic therapy (PDT). We conducted retrospective analyses regarding the choice of therapy for pCSC in the best clinical practice and the outcomes of these modalities.Study designA retrospective interventional study.MethodsThe records of 71 eyes of 68 treatment naïve pCSC cases who underwent PC, SRT, or PDT were reviewed. First, the baseline clinical parameters were evaluated to find significant factors associated with the choice of treatment option. Second, the 3 months’ visual and anatomical outcomes of each modality were assessed.ResultsThe PC, SRT, and PDT groups included 7, 22, and 42 eyes, respectively. The leakage pattern in fluorescein angiography (FA) was significantly associated with the choice of treatment (p<0.005). The dry macula ratio at 3 months post-treatment was 29%, 59%, and 81% in the PC, SRT, and PDT groups, respectively, which significantly differed among the groups (p<0.01). The best-corrected visual acuities tended to be improved after the treatments in all groups. Central choroidal thickness (CCT) was significantly decreased in all groups (p<0.05, p<0.01, and p<0.00001, in PC, SRT, and PDT groups, respectively). Logistic regression analysis for dry macula revealed that SRT (p<0.05), PDT (p<0.05), and the changes in CCT (p<0.01)were the significant association factors.ConclusionThe leakage pattern in FA was associated with the choice of treatment option for pCSC. PDT achieved a significantly higher dry macula ratio than PC, 3 months after the treatment.