光动力疗法联合抗血管内皮生长因子药物治疗脉络膜新生血管的进展

Progress of photodynamic therapy combined with anti-VEGF for patients with choroidal neovascularization

脉络膜新生血管(choroidal neovascularization,CNV)是多种眼底病致盲的主要原因,好发于黄斑区,严重影响中心视力。CNV常用治疗包括相对选择性治疗——光动力疗法(photodynamic therapy,PDT)、选择性治疗——抗血管内皮生长因子(anti-vascular endothelial growth factor,VEGF)药物。但PDT治疗后视力不提高,还可上调VEGF的表达、继发炎症反应;抗VEGF药物需多次注射以维持疗效,进而带来不良反应的风险和经济负担。目前,PDT联合抗VEGF药物治疗CNV在基础与临床研究方面均取得一定进展,使得联合疗法成为CNV治疗的选择之一。为了减少治疗后的不良反应,实施联合疗法时是否变更PDT治疗参数需要进一步研究。

Choroidal neovascularization（ CNV） is a common severe complication of ocular fundus diseases, with great potentiality to cause blindness. The treatments of CNV include photodynamic therapy （ PDT ） and anti-vascular endothelial growth factor（ VEGF） therapy. However, PDT produces little visual benefits, and may result in ischemia, inflammatory responses, even the secondary expressions of VEGF. Anti-VEGF therapy sustained visual efficiency by repeated injections, causing economic burden and adverse effects related to injection. Recently, PDT combined with anti-VEGF therapy has progressed in laboratory and clinical research. Therefore, the combined modality therapy became one of the treatment options for CNV. In order to reduce the side effects of mono -therapy, further study is required to determine appropriate combinations and dosage.