光动力学疗法治疗脉络膜新生血管的临床疗效

Photodynamic Therapy for Choroidal Neovascularization:Clinical Observations

目的观察光动力学疗法(photodynamic therapy,PDT)治疗脉络膜新生血管(choroidal neovascularization,CNV)的近期临床疗效。方法对70例(88只眼)CNV患者行PDT治疗。以治疗前、后第1周,1、3、6和12个月的视力,荧光素眼底血管造影、吲哚菁绿血管造影及光学相干断层成像术的检查结果作为临床观察指标,评价PDT治疗CNV的疗效。结果治疗后第1个月复诊,78只眼视力提高,占88．6%；8只眼视力稳定,占9．1%；2只眼视力下降,占2．3%。治疗后第3个月,73只眼视力提高,占83．0%；12只眼视力稳定,占13．6%；3只眼视力下降,占3．4%。治疗后第6个月,73只眼视力提高,占83．0%；10只眼视力稳定,占11．4%；5只眼视力下降,占5．7%。治疗后第12个月,72只眼视力提高,占81．8%；10只眼视力稳定,占11．4%；6只眼视力下降,占6．8%。结论PDT可单次或重复治疗黄斑部CNV,封闭新生血管后可使渗漏消退或减轻,是改善或稳定患者视功能的安全、有效方法。

Objective To observe the clinical effect of photodynamic therapy(PDT) on choroidal neovascularization(CNV). Methods Eighty eight eyes of 70 patients with CNV had been under PDT.The index of clinical effect by which we observed and eval- uated PDT on CNV patients was visual acuity(1 week before the treatment,1 week and 1,3,6,12months after the treatment)and the results of fundus fluorescein angiography(FFA),indocyanine green angiography(ICGA)and optic coherence tomography(OCT). Results One month after the treatment,the visual acuity of 78 eyes improved,accounting for 88.6%;that of 8 eyes,unchanged,ac- counting for 9.1%;and of 2 eyes,declined,accounting for 2.3%.Three months after the treatment,the visual acuity of 73 eyes im- proved,accounting for 83.0%;of 12 eyes,unchanged,accounting for 13.6% ;and of 3 eyes,declined,accounting for 3.4%.Six months after the treatment,the visual acuity of 73 eyes improved,accounting for 83.0%,of 10 eyes,unchanged,aeeounting for 11.4%;and that of 5 eyes,declined,accounting for 5.7%.Twelve months after treatment,the visual acuity of 72 eyes improved,ac- counting for 81.8%;that of 10 eyes,unchanged,accounting for 11.4% ;and of 6 eyes,declined,accounting for 6.8%. Conclusions PDT can be done on CNV in the macular region once or repeatedly.After neovascularization is sealed,the exudation will disappear or be relieved.So PDT is a safe and effective means to improve or stabilize the visual acuity of CNV patients.