Standard-Fluence versus Low-Fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy: A Nonrandomized Clinical Trial
Standard-Fluence versus Low-Fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy: A Nonrandomized Clinical Trial
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DOI：
10.1016/j.ajo.2009.08.026
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发表时间：
2010-02-01
影响因子：
4.2
通讯作者：
Boscia, Francesco
中科院分区：
文献类型：
--
作者：
Reibaldi, Michele;Cardascia, Nicola;Boscia, Francesco
目的：评价低通量光动力疗法与标准通量光动力疗法（PDT）治疗慢性中枢性浆液性脉络膜视网膜病变的疗效。设计：前瞻性、多中心、研究者隐匿、非随机临床试验。方法：42例慢性中枢性浆液性脉络膜视网膜病变患者；19眼接受吲哚青绿血管造影引导下的标准流量PDT (50 J/cm(2))， 23眼接受吲哚青绿血管造影引导下的低流量PDT （25 J/cm(2)）。主要观察指标为最佳矫正视力最小分辨角的平均对数变化和视网膜下液体完全再吸收的眼率。次要结果是中央凹厚度和脉络膜灌注的变化。结果：最佳矫正视力最小分辨角的平均对数在所有时间点均有显著改善（P < 0.01），标准影响组12个月时从0.43提高到0.24，低影响组从0.46提高到0.16，两组间无显著差异。12个月时，15只标准氟治疗眼和21只低氟治疗眼的视网膜下液完全重吸收（79% vs 91%; P = 0.5）。1只标准剂量眼在3个月时出现脉络膜新生血管，并进一步接受PDT治疗；在另一只眼，12个月时，8只标准氟治疗眼和0只低氟治疗眼出现中度明显的绒毛毛细血管无灌注（44% vs 0%; P = 0.002）。结论：在大多数眼睛中，标准流量PDT和低流量PDT均可导致视网膜下液完全重吸收，并改善视力。低流量PDT可减轻与PDT相关的脉络膜灌注不足。[J]中华眼科杂志，2010;39(4):391 - 391。(C) 2010年Elsevier Inc.版权所有。)
PURPOSE: To evaluate the efficacy of low-fluence compared with standard-fluence rate photodynamic therapy (PDT) for treating chronic central serous chorioretinopathy.DESIGN: Prospective, multicenter, investigator-masked, nonrandomized clinical trial.METHODS: Forty-two eyes (42 patients) with chronic central serous chorioretinopathy were enrolled; 19 eyes received indocyanine green angiography-guided standard-fluence PDT (50 J/cm(2)) and 23 eyes received indocyanine green angiography-guided low-fluence PDT (25 J/cm(2)). Primary outcome measures were the changes in mean logarithm of the minimal angle of resolution best-corrected visual acuity and the rate of eyes with complete subretinal fluid reabsorption. Secondary outcomes were the changes in central foveal thickness and choroidal perfusion.RESULTS: Mean logarithm of the minimal angle of resolution best-corrected visual acuity improved significantly at all time points (P < .01), in the standard-fluence group from 0.43 to 0.24 at 12 months and in the low-fluence-group from 0.46 to 0.16, without significant difference between the 2 groups. At 12 months, a complete subretinal fluid reabsorption was seen in 15 standard-fluence-treated and 21 low-fluence-treated eyes (79% vs 91%; P = .5). In 1 standard-fluence eye, choroidal neovascularization developed at 3 months, and this eye received further PDT; in the other eyes, at 12 months, a moderate-significant choriocapillaris nonperfusion was seen in 8 standard-fluence-treated and 0 low-fluence-treated eyes (44% vs 0%; P = .002).CONCLUSIONS: In most of the eyes, both standard-fluence PDT and low-fluence PDT resulted in complete subretinal fluid reabsorption with visual acuity improvement. Choroidal hypoperfusion related to PDT could be reduced by low-fluence PDT. (Am J Ophthalmol 2010;149:307-315. (C) 2010 by Elsevier Inc. All rights reserved.)