Choroidal thickness following extrafoveal photodynamic treatment with verteporfin in patients with central serous chorioretinopathy
Choroidal thickness following extrafoveal photodynamic treatment with verteporfin in patients with central serous chorioretinopathy
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DOI：
10.1111/j.1755-3768.2011.02157.x
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发表时间：
2012-12-01
影响因子：
3.4
通讯作者：
Larsen, Michael
中科院分区：
文献类型：
--
作者：
Pryds, Anders;Larsen, Michael
目的：评估维替泊芬光动力治疗（PDT）对中心性浆液性脉络膜视网膜病变（CSC）患者脉络膜厚度的影响。方法：对16例因中心凹外血管造影荧光素渗漏导致中心凹浆液性脱离的患者的16只眼，在维替泊芬PDT（全剂量维替泊芬，半光剂量）治疗前后，使用增强深度成像光学相干断层扫描（EDIOCT）测量脉络膜厚度。治疗局限于渗漏区域，而使用光学相干断层扫描在眼底更大区域评估治疗前后的脉络膜厚度。结果：在中心凹外PDT治疗1个月内，16只眼的浆液性脱离均完全消退，同时PDT治疗区域的脉络膜厚度从407μm（平均值；95%置信区间（CI95）356 - 458μm）降至349μm（平均值；CI95 300 - 399μm；p < 0.0001），中心凹下脉络膜厚度从421μm（平均值；CI95 352 - 489μm）降至346μm（平均值；CI95 278 - 414μm；p = 0.0001）。最初，与健康对侧眼相比，治疗眼的中心凹下脉络膜厚度显著增加（平均值324μm；CI95 273 - 376μm；p = 0.0003），但治疗后差异不显著。讨论：活动性CSC的光动力治疗后脉络膜厚度降低，不仅在局部，而且在距治疗区域相当远的地方也是如此。因此，CSC中导致脉络膜增厚的过程似乎在脉络膜内横向扩散。
. Purpose: To evaluate the effect of verteporfin photodynamic treatment (PDT) on choroidal thickness in patients with central serous chorioretinopathy (CSC). Methods: Choroidal thickness was measured with enhanced depth imaging optical coherence tomography (EDIOCT) before and after verteporfin PDT (full-dose verteporfin, half-light dose) in 16 eyes in 16 patients with serous detachment of the fovea secondary to extrafoveal angiographic fluorescein leakage. Treatment was confined to the area of leakage, whereas choroidal thickness before and after treatment was assessed over a larger area of the fundus using OCT. Results: Complete resolution of the serous detachment was seen in all 16 eyes within 1 month of extrafoveal PDT, while choroidal thickness in the area where PDT was applied decreased from 407 mu m [mean; 95% confidence interval (CI95) 356458 mu m] to 349 mu m (mean; CI95 300399 mu m; p < 0.0001), and subfoveal choroidal thickness was reduced from 421 mu m (mean; CI95 352489 mu m) to 346 mu m (mean; CI95 278414 mu m; p = 0.0001). Initially, subfoveal choroidal thickness was significantly increased in the treated eye compared with the healthy fellow eye (mean 324 mu m; CI95 273376 mu m; p = 0.0003), but after treatment, the difference was not significant. Discussion: Photodynamic therapy of active CSC was followed by choroidal thickness reduction, not only locally but also at considerable distance from the treated area. Thus, the process that causes choroidal thickening in CSC appears to spread laterally within the choroid.