黄斑中心凹下脉络膜新生血管光动力疗法治疗后黄斑区对比敏感度变化

Changes of contrast sensitivity in macular area before and after photodynamic therapy in patients with subfoveal choroidal neovascularization

目的观察黄斑中心凹下脉络膜新生血管（CNV）光动力疗法（PDT）治疗前后对比敏感度（CS）的变化。方法回顾分析29例PDT治疗的患者32只眼治疗前以及治疗后2周、1、3、6个月、1年时视力、对比度视力、CS检查的临床资料。结果治疗后6个月时，视力稳定者占50％，提高者占40．9％，降低者占9．1％。平均高对比度视力均较治疗前有所提高。治疗后2周、3个月时，低频区CS与治疗前相比均有显著性差异（P=0．043、P=0．037）。6个月时，中频区间频率与治疗前比较有显著性差异（P=0．048），高频区间治疗前后均无改变。年龄以及光斑直径对CS无显著影响。结论PDT治疗黄斑中心凹下CNV短期内可改善患者的视力、对比度视力和CS，但是长期随访仍十分必要。

Objective To investigate the changes of contrast sensitivity in macular area of patients with subfoveal choroidal neovascularization （CNV） before and after photodynamic therapy （PDT）. Methods The clinical data of 29 consecutive patients （32 eyes） undergone PDT for subfoveal CNV were retrospectively analyzed. The best corrected visual acuity, contrast visual acuity and contrast sensitivity frequency before the treatment and 2 weeks, 1 month, 3 months, 6 months, and 1 year after PDT were inspected. Results Six months after PDT, the best corrected visual acuity kept stable in 50% patients, improved in 40. 9% ,and decreased in 9.1%. The average high-contrast visual acuity was better after PDT than which before PDT. Two weeks and 3 months after PDT, the contrast sensitivity alteration of low spatial frequencies differed significantly from which before the treatment （P = 0. 043, P = 0. 037）. Six months after PDT, contrast sensitivity alteration of middling spatial frequencies significantly different from which before the treatment （P= 0. 048）; however, no difference of contrast sensitivity of high spatial frequencies before and after PDT was found. Age and light-spot diameter had no distinct influence on contrast sensitivity. Conclusion PDT for subfoveal choroidal neovascularization in macular area may improve the best corrected visual acuity, contrast visual acuity and contrast sensitivity frequency in a short term, however, the long-term fellow-up observation is necessary.