半剂量维替泊芬与半能量光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变

发布时间：2018-05-13 19:05

本文选题：光动力学疗法 + 慢性中心性浆液性脉络膜视网膜病变　；参考：《眼科新进展》2017年04期

【摘要】：目的比较半剂量维替泊芬光动力与半能量光动力疗法(photodynamic therapy,PDT)对慢性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)治疗的有效性和安全性。方法回顾性队列病例研究。将我院门诊确诊为慢性CSC患者42例(42眼)纳入研究。根据患者PDT治疗过程中所接受的药物剂量和激光参数的不同分为半剂量和半能量组。半剂量组22例(22眼)接受半剂量维替泊芬(3 mg·m~(-2))和标准能量PDT(83 s,50 J·cm~(-2))治疗。半能量组20例(20眼)接受全剂量维替泊芬(6 mg·m~(-2))和半能量PDT(42 s,25 J·cm~(-2))治疗。PDT治疗后1、3、6个月随访,观察两组患者视网膜下液(subretinal fluid,SRF)完全吸收的比例,最佳矫正视力(best corrected visual acuity,BCVA)变化和黄斑部视网膜厚度(central macular thickness,CMT)的变化。结果治疗后6个月,半剂量组患者22眼(100%)SRF完全吸收,半能量患者19例(95%)SRF完全吸收,两组间治愈率比较差异无统计学意义(P0.05);治疗后6个月,半剂量组BCVA提高7.2字母,半能量组BCVA提高6.7个字母,BCVA提高字母数两组间比较差异无统计学意义(P0.05)。治疗前半剂量组CMT为(351±90)μm,治疗后6个月降至(178±55)μm,治疗前后比较差异有统计学意义(P0.05),半能量组CMT治疗前为(322±96)μm,治疗后6个月降至(181±47)μm,治疗前后比较差异有统计学意义(P0.05)。所有患者均未出现视网膜色素上皮萎缩、脉络膜新生血管形成等并发症。结论半剂量维替泊芬光动力和PDT治疗慢性CSC同样安全有效。
[Abstract]:Objective to compare the efficacy and safety of half dose vitipofen photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (serous). Methods retrospective cohort study. 42 patients with chronic CSC (42 eyes) were included in the study. The patients were divided into half dose and half energy groups according to the drug dose and laser parameters received during the treatment of PDT. Half dose group (22 eyes) were treated with metipofen (3 mg / ml) and standard energy (PDT(83 / 50 J / cm ~ (-2). In the half-energy group (n = 20, n = 20) received full dose of metipofen (6 mg / ml) and half-energy PDT(42 (25 J 路cm ~ (-2). The patients were followed up for 1, 3 and 6 months after treatment. The complete absorption ratio of subretinal fluid (SRF) was observed in both groups. Changes of best corrected visual acuity and central macular thickness of macular retina. Results after 6 months of treatment, 22 eyes of the half-dose group were completely absorbed, and 19 cases of half-energy patients were completely absorbed. There was no significant difference in the cure rate between the two groups (P 0.05), and the BCVA in the half-dose group increased 7.2letter at 6 months after treatment. There was no significant difference between the two groups in the increase of BCVA and the number of letters in the half energy group (P 0.05). The CMT of the first half dose group was 351 卤90 渭 m, and decreased to 178 卤55 渭 m 6 months after treatment. The difference was statistically significant before and after treatment (P 0.05). The CMT in the half energy group was 322 卤96 渭 m before treatment and 181 卤47 渭 m at 6 months after treatment. There was a significant difference before and after treatment (P 0.05). No complications such as retinal pigment epithelium atrophy and choroidal neovascularization were found in all patients. Conclusion the half dose of vitipofen photodynamic therapy is as safe and effective as PDT in the treatment of chronic CSC.
【作者单位】：西安市第四医院眼科;
【基金】：陕西省科技厅社会发展科技攻关项目(编号:2015SF232;2015SF085;2015SF106) 西安市科技局社会发展引导计划-医学研究项目[编号:SF1513(3)]~~
【分类号】：R774.1

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