中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2014年
4期
369-373
,共5页
潘中婷%赵明威%董冲亚%曲进锋%李宏彦%魏航%李岩%刘国栋%徐秀兰
潘中婷%趙明威%董遲亞%麯進鋒%李宏彥%魏航%李巖%劉國棟%徐秀蘭
반중정%조명위%동충아%곡진봉%리굉언%위항%리암%류국동%서수란
中心性浆液性脉络膜视网膜病变/治疗%光敏感药/投药和剂量%光化学疗法%治疗结果
中心性漿液性脈絡膜視網膜病變/治療%光敏感藥/投藥和劑量%光化學療法%治療結果
중심성장액성맥락막시망막병변/치료%광민감약/투약화제량%광화학요법%치료결과
Central serous chorioretinopathy /therapy%Photosensitizing agents/administration & dosage%Photochemotherapy%Treatment outcome
目的 对比观察30％、50％剂量维替泊芬光动力疗法(PDT)治疗急性中心性浆液性脉络膜视网膜病变(CSC)的疗效.方法 回顾性队列病例研究.2007年3月至2013年8月行30％、50％剂量维替泊芬治疗的急性CSC患者88例92只眼纳入研究.患眼均行最佳矫正视力(BCVA)检查,统计时转换为最小分辨角对数(LogMAR)视力;间接检眼镜、彩色眼底照相、荧光素眼底血管造影、吲哚青绿血管造影、频域光相干断层扫描(SD-OCT)检查.92只眼中,50％剂量49只眼(50％剂量组);30％剂量43只眼(30％剂量组).两组患者平均年龄(t=-1.45)、性别(x2=0.011)、眼别(x2=2.140)、平均logMAR BCVA(t=-0.40)、平均中心凹视网膜厚度、平均浆液脱离最高处视网膜厚度比较,差异无统计学意义(P＞0.05);光斑大小(t=-2.84)比较,差异有统计学意义(P＜0.05).治疗后随访6～68个月,平均随访时间(17.16±11.30)个月.两组患者随访时间比较,差异无统计学意义(P＞0.05).观察BCVA变化;根据SD-OCT检查结果,评定治愈率、复发率、中心凹视网膜厚度和浆液脱离最高处视网膜厚度变化.Logistic多因素回归分析治疗光斑与治疗结局的关系.结果 30％剂量组43只眼中,视网膜下液完全吸收31只眼,治愈率72.09％;50％剂量组49只眼中,视网膜下液完全吸收47只眼,治愈率95.92％.两组治愈率比较,差异有统计学意义(x2=10.077,P=0.020).Logistic回归分析结果显示,治疗分组和光斑大小对患者治愈结局的影响呈显著负相关(比值比＞1,P=0.040).随访时间12个月以上者,50％剂量组logMAR BCVA优于30％剂量组,差异有统计学意义(P=0.036).治疗后3、6、12个月及以上,50％剂量组中心凹视网膜厚度与30％剂量组比较,差异无统计学意义(P=0.068、0.060、0.082、0.067).两组浆液脱离最高处视网膜厚度变化比较,差异无统计学意义(P＞0.05).30％剂量组治愈31只眼中,视网膜下液再次出现8只眼,复发率25.81％;50％剂量组治愈47只眼中,视网膜下液再次出现1只眼,复发率2.13％.两组复发率比较,差异有统计学意义(P＜0.05).结论 50％剂量维替泊芬PDT治疗急性CSC,疗效优于30％剂量.
目的 對比觀察30％、50％劑量維替泊芬光動力療法(PDT)治療急性中心性漿液性脈絡膜視網膜病變(CSC)的療效.方法 迴顧性隊列病例研究.2007年3月至2013年8月行30％、50％劑量維替泊芬治療的急性CSC患者88例92隻眼納入研究.患眼均行最佳矯正視力(BCVA)檢查,統計時轉換為最小分辨角對數(LogMAR)視力;間接檢眼鏡、綵色眼底照相、熒光素眼底血管造影、吲哚青綠血管造影、頻域光相榦斷層掃描(SD-OCT)檢查.92隻眼中,50％劑量49隻眼(50％劑量組);30％劑量43隻眼(30％劑量組).兩組患者平均年齡(t=-1.45)、性彆(x2=0.011)、眼彆(x2=2.140)、平均logMAR BCVA(t=-0.40)、平均中心凹視網膜厚度、平均漿液脫離最高處視網膜厚度比較,差異無統計學意義(P＞0.05);光斑大小(t=-2.84)比較,差異有統計學意義(P＜0.05).治療後隨訪6～68箇月,平均隨訪時間(17.16±11.30)箇月.兩組患者隨訪時間比較,差異無統計學意義(P＞0.05).觀察BCVA變化;根據SD-OCT檢查結果,評定治愈率、複髮率、中心凹視網膜厚度和漿液脫離最高處視網膜厚度變化.Logistic多因素迴歸分析治療光斑與治療結跼的關繫.結果 30％劑量組43隻眼中,視網膜下液完全吸收31隻眼,治愈率72.09％;50％劑量組49隻眼中,視網膜下液完全吸收47隻眼,治愈率95.92％.兩組治愈率比較,差異有統計學意義(x2=10.077,P=0.020).Logistic迴歸分析結果顯示,治療分組和光斑大小對患者治愈結跼的影響呈顯著負相關(比值比＞1,P=0.040).隨訪時間12箇月以上者,50％劑量組logMAR BCVA優于30％劑量組,差異有統計學意義(P=0.036).治療後3、6、12箇月及以上,50％劑量組中心凹視網膜厚度與30％劑量組比較,差異無統計學意義(P=0.068、0.060、0.082、0.067).兩組漿液脫離最高處視網膜厚度變化比較,差異無統計學意義(P＞0.05).30％劑量組治愈31隻眼中,視網膜下液再次齣現8隻眼,複髮率25.81％;50％劑量組治愈47隻眼中,視網膜下液再次齣現1隻眼,複髮率2.13％.兩組複髮率比較,差異有統計學意義(P＜0.05).結論 50％劑量維替泊芬PDT治療急性CSC,療效優于30％劑量.
목적 대비관찰30％、50％제량유체박분광동력요법(PDT)치료급성중심성장액성맥락막시망막병변(CSC)적료효.방법 회고성대렬병례연구.2007년3월지2013년8월행30％、50％제량유체박분치료적급성CSC환자88례92지안납입연구.환안균행최가교정시력(BCVA)검사,통계시전환위최소분변각대수(LogMAR)시력;간접검안경、채색안저조상、형광소안저혈관조영、신타청록혈관조영、빈역광상간단층소묘(SD-OCT)검사.92지안중,50％제량49지안(50％제량조);30％제량43지안(30％제량조).량조환자평균년령(t=-1.45)、성별(x2=0.011)、안별(x2=2.140)、평균logMAR BCVA(t=-0.40)、평균중심요시망막후도、평균장액탈리최고처시망막후도비교,차이무통계학의의(P＞0.05);광반대소(t=-2.84)비교,차이유통계학의의(P＜0.05).치료후수방6～68개월,평균수방시간(17.16±11.30)개월.량조환자수방시간비교,차이무통계학의의(P＞0.05).관찰BCVA변화;근거SD-OCT검사결과,평정치유솔、복발솔、중심요시망막후도화장액탈리최고처시망막후도변화.Logistic다인소회귀분석치료광반여치료결국적관계.결과 30％제량조43지안중,시망막하액완전흡수31지안,치유솔72.09％;50％제량조49지안중,시망막하액완전흡수47지안,치유솔95.92％.량조치유솔비교,차이유통계학의의(x2=10.077,P=0.020).Logistic회귀분석결과현시,치료분조화광반대소대환자치유결국적영향정현저부상관(비치비＞1,P=0.040).수방시간12개월이상자,50％제량조logMAR BCVA우우30％제량조,차이유통계학의의(P=0.036).치료후3、6、12개월급이상,50％제량조중심요시망막후도여30％제량조비교,차이무통계학의의(P=0.068、0.060、0.082、0.067).량조장액탈리최고처시망막후도변화비교,차이무통계학의의(P＞0.05).30％제량조치유31지안중,시망막하액재차출현8지안,복발솔25.81％;50％제량조치유47지안중,시망막하액재차출현1지안,복발솔2.13％.량조복발솔비교,차이유통계학의의(P＜0.05).결론 50％제량유체박분PDT치료급성CSC,료효우우30％제량.
Objective To evaluate the efficacy of 30％ and 50％ dose photodynamic therapy (PDT) for acute central serous chorioretinopathy (CSC).Methods A retrospective cohort study.Ninety-two eyes of 88 patients with CSC,diagnosed by best corrected visual acuity (BCVA) of logarithm of the minimum angle of resolution (logMAR),indirect ophthalmoscope,fundus colorized photography,fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) and optical coherence tomography (SD-OCT) treated with 30％ and 50％ doses of verteporfin respectively between March 2007 and August 2013,were enrolled.The eyes were divided into 50％ dose group (49 eyes) and 30％ dose group (43 eyes).The differences of age (t=-1.45),gender (x2=0.011),eyes (x2 =2.140),mean logMAR BCVA (t=-0.40),mean central retinal thickness (CRT) and the maximum thickness of serous retinal detachment (SRD) between two groups were not significant (P＞0.05).The difference of spot size between two groups was significant (t=-2.84,P＜0.05).The follow-up time was ranged from 6 to 68 months,with a mean of (17.16 ±11.30) months.The difference of follow-up between two groups was significant (P＞0.05).The BCVA,cure rate,recurrence rate and the changes of CRT and maximum SRT were observed by SD-OCT.Results The subretinal fluid (SRF) of 31 eyes (72.09％) in the 30％ dose group and that of 47 eyes (95.92％) in the 50％ dose PDT group was absorbed completely respectively.The cure rates in the 30％ dose PDT group was significantly less than that in the 50％ dose group (x2=10.077,P=0.020).There was a significant negative association between the cure rate and spot size by Logistic regression (odds ratio＞1,P=0.040).The difference of changes in the BCVA of logMAR in 50％ dose group was better than that in 30％ dose group after more than 12 months after PDT (P=0.036).On 3,6,12 and more than 12 months after PDT,the difference in CRT in 50％ dose group and 30％ dose group were not statistically significant (P =0.068,0.060,0.082,0.067).The difference in maximum thickness of SRD was not statically significant (P＞0.05).SRF was appeared in 8 eyes (25.81％) of 31 eyes in the 30％ dose group,while SRF was appeared in 1 eye (2.13％) of 47 eyes in the 50％ dose group.The recurrence rate of 30％ dose group was much higher than that of 50％ dose group (P＜0.05).Conclusions For acute CSC treated by PDT,the curative effect of 50 ％ dose group is better than the 30 ％ dose group.
