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首页> 外文期刊>British journal of ophthalmology >Choroidal vascular remodelling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level.
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Choroidal vascular remodelling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level.

机译：吲哚菁绿引导的Verteporfin光动力疗法治疗中心性浆液性脉络膜视网膜病变的脉络膜血管重塑：一种在原发疾病水平的新型治疗方法。

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AIMS: To evaluate the changes in the choroidal vasculature in central serous chorioretinopathy (CSC) after photodynamic therapy (PDT) with verteporfin and to assess its potential role as a treatment option. METHODS: A prospective, non-comparative, interventional study was performed in eyes with persistent CSC or chronic CSC that had fluorescein leakage at the fovea. All eyes received one single session of PDT with verteporfin (6 mg/m2 body surface area) followed by application of 50 J/cm2 laser at 689 nm. The laser spot size was guided by findings in ICG-A. RESULTS: Six eyes from six patients with a mean follow up of 12.7 months were analysed. Narrowing of the original dilated choroidal vessels and decrease in extravascular leakage could be demonstrated in all (100%) PDT treated eyes. 3 months after PDT, the mean diameter of the dilated choroidal vessel reduced from 546 microm to 371 microm (p=0.028). Five (83%) patients had improvement in visual symptoms and best corrected visual acuity. Fluorescence leakage stopped at the 1 month follow up in five eyes (83%) and at 3 months in all six eyes (100%). One eye developed choroidal neovascularisation at 3 month follow up. There was no other serious ocular or systemic complication. CONCLUSIONS: PDT is successful in stopping the fluorescein leakage in all six patients without recurrence of CSC. The ICG-A findings of choroidal vascular remodelling and decreased choroidal permeability after PDT are encouraging. As the sample size is small and the mean follow up period is short, further trials of PDT with verteporfin for CSC are required to address the optimal parameters in ensuring longer term safety and efficacy outcome.
机译：目的：评估使用维替泊芬进行光动力治疗（PDT）后中心性浆液性脉络膜脉络膜视网膜病变（CSC）中脉络膜脉管系统的变化，并评估其作为治疗选择的潜在作用。方法：对患有持续性CSC或慢性CSC且在中央凹处有荧光素渗漏的眼睛进行了一项前瞻性，非对照性干预研究。所有眼睛均接受单次PDT治疗并使用维替泊芬（6 mg / m2体表面积），然后在689 nm处施加50 J / cm2激光。激光光斑的大小由ICG-A中的发现指导。结果：分析了六名患者的六只眼，平均随访时间为12.7个月。在所有（100％）PDT治疗的眼中均可证明原始扩张的脉络膜血管变窄和血管外渗漏的减少。 PDT后3个月，扩张的脉络膜血管的平均直径从546微米降至371微米（p = 0.028）。五名患者（83％）的视觉症状有所改善，矫正视力最佳。五只眼（83％）在1个月随访中停止了荧光渗漏，六只眼（3％）在3个月时停止了荧光渗漏。一只眼睛在随访3个月时出现脉络膜新生血管。没有其他严重的眼或全身并发症。结论：PDT成功地阻止了6例患者中的荧光素渗漏，而CSC未复发。 PDT后脉络膜血管重塑和脉络膜通透性降低的ICG-A结果令人鼓舞。由于样本量小且平均随访时间短，因此需要对维甲酸加维替泊芬治疗CSC进行PDT的进一步试验，以找到最佳参数，以确保长期安全性和疗效。

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