光动力疗法治疗病理性近视所致黄斑部CNV的临床疗效观察

Therapeutic effect of photodynamic therapy on choroidal neovascularization of pathologic myopia

目的:评价光动力疗法(photodynamic therapy,PDT)治疗病理性近视所致黄斑部脉络膜新生血管(choroidal neovascularization,CNV)的临床疗效。方法:回顾性分析20例21眼临床确诊为病理性近视合并CNV患者的临床资料,对比分析PDT治疗前后患者最佳矫正视力(BCVA)、固视性质,FFA/ICGA和OCT等检查结果的变化。结果:PDT治疗后随访6mo,1例患者PDT治疗后3mo因玻璃体积血行玻璃体切除手术,未继续随访。其余患者BCVA与治疗前相比明显提高,差异具有统计学意义(P<0.05)。PDT治疗前中心固视3眼,中心外固视18眼,随访期间固视性质未发生改变。FFA/ICGA检查显示,PDT治疗后3mo,CNV病灶渗漏停止或渗漏减少者18眼(86%),持续渗漏2眼(10%),1眼出现玻璃体积血。PDT治疗后6mo,CNV病灶渗漏停止或渗漏减少者19眼(90%),持续渗漏1眼(5%),OCT显示CNV缩小,组织水肿减轻。结论:PDT治疗可以部分或完全封闭病理性近视所致脉络膜CNV,减少CNV引起的视力下降危险性。

AIM：To investigate the efficacy of photodynamic therapy（PDT） on macular choroidal neovascularization（CNV） of pathologic myopia（PM）.METHODS：Twenty patients 21 eyes who were diagnosed with PM were analyzed retrospectively.The changes in the best-corrected visual acuity（BCVA）,fixation nature,fundus examination,FFA/ICGA and OCT were analyzed before and after PDT treatment.RESULTS：During 6 months follow-up,only 1 case was performed vitrectomy because of vitreous hemorrhage 3 months after PDT.Compared with pre-treatment of PDT,the BCVA of other patients was improved（P0.05）.Before PDT treatment,3 eyes were central fixation and 18 eyes were paracentral fixation.The fixation characteristic was not changed after PDT.3 months after PDT,FFA/ICGA showed no leakage or reduced leakage in 18 eyes（86%）.In 2 eyes,the fundus remained leaky,1 eye was not followed because of vitreous hemorrhage and performing vitrectomy.In the six-month follow-up,FFA/ICGA showed no leakage or slight leakage in 19 eyes（90%） and continous leakage in 1 eye（5%）.CONCLUSION：PDT can block CNV of PM completely or partly,and reduce the danger of vision loss.