光动力疗法治疗黄斑区脉络膜新生血管临床观察

Clinical study of photodynamic therapy for macula choroidal neovascularization

目的研究以维替泊芬为光敏剂的光动力疗法(PDT)对黄斑区脉络膜新生血管(CNV)的治疗效果。方法回顾性分析40例45眼经荧光素眼底血管造影(FFA)、吲哚青绿脉络膜血管造影(ICGA)及光学相干断层扫描(OCT)检查确诊的黄斑区CNV患者临床资料,包括PDT治疗后12周及24周的视力、眼底改变及OCT检查结果。结果治疗后12周视力提高10眼(22.2%),视力保持不变35眼(77.8%),无患眼视力下降。FFA/ICGA检查示CNV病灶消退21眼(46.7%),CNV病灶减轻15眼(33.3%),CNV病灶复发9眼(20.0%)。治疗后24周复查,视力提高23眼(51.1%),保持不变21眼(46.7%),视力下降1眼(2.2%)。CNV病灶消退40眼(88.9%);CNV病灶复发5眼(11.1%)。未发现与药物有关的全身或眼部不良反应。结论 PDT治疗黄斑区CNV安全有效,能减轻CNV的渗漏。

Objectives To observe the clinical efficacy of verteporfin photodynamic therapy （PDT） for in patients with maeular choroidal neovascularization （ CNV ）. Methods Forty five eyes of forty patients with CNV were analyzed retrospectively. All patients had been diagnosed with macular CNV by fundus fluores-cein angiography （FFA）, indole green choroid angiography（ICGA） and optical coherence tomography（OCT）. Vision, ocular fundus and OCT were observed at 12 weeks and 24 weeks after PDT. Results Twelve weeks after PDT, visual acuity improved in 10 eyes （22. 2% ） , keep no change in 35 eyes （77.8%） , no eye had vi-sion loss. The result of FFA/ICGA showed： no leakage of CNV in 21 eyes （46. 7% ） , less leakage of CNV in 15 eyes （33.3%） , CNV recurrence in 9 eyes （20.0%）. At 24 weeks after treatment, visual acuity improved in 23 eyes （51.1%） , remained unchange in 23 eyes （46. 7% ） and vision loss was found in 1 eye. Forty eyes （88.9%） had CNV closure, 5 eyes （ 11.1% ） had recurrent CNV. No adverse reactions were observed during follow-up. Conclusions PDT is a safe and effective treatment for macular CNV, which can reduce leakage of CNV.