特发性脉络膜新生血管光动力疗法的疗效观察  

Evaluation of photodynamic therapy in idiopathic choroidal neovascularization

作　　者：苏兆安[1] 姚克[1] 沈洁[2] 姜节凯[1] 方肖云[1] 林季建[1] 杜新华[1] 

机构地区：[1]浙江大学医学院附属第二医院眼科中心,杭州310009 [2]浙江大学医学院附属第一医院浙益眼科中心

出　　处：《中华眼科杂志》2007年第6期509-513,共5页Chinese Journal of Ophthalmology

摘　　要：目的观察光动力疗法（PDT）对特发性脉络膜新生血管（CNV）的治疗效果。方法对61例（61只眼）经荧光素眼底血管造影（FFA）和吲哚氰绿眼底血管造影（ICGA）确诊的特发性CNV患者行PDT治疗，观察比较治疗前后眼底形态、视力、视网膜厚度、FFA和ICGA图像特征。PDT平均治疗次数为1、2次。随访时间为6～36个月，平均19个月。结果末次随访时，61只眼中，有41只眼视力提高（67.2％），15只眼视力无明显变化（24.6％），5只眼视力下降（8.2％）。经治疗后所有患眼黄斑出血及渗出均明显减轻。FFA图像显示38只眼的CNV荧光素渗漏完全消失，CNV闭合或瘢痕形成（62．3％）；4只眼CNV部分闭合（6.6％），14只眼CNV小部分闭合（23．0％），5只眼CNV复发（8．2％）。6只眼经1次PDT治疗CNV完全闭合，相干光断层扫描或视网膜厚度检查可见黄斑区神经上皮脱离及视网膜水肿消失，随访时间最长3年，未见CNV复发，视力保持稳定。研究结果经多重线性回归分析，表明治疗效果与年龄有关（t=0．476，P=0．016），即年龄每提高一岁，治疗后视力平均下降0．008（95％CI为0．002～0．015）。结论PDT对特发性CNV有较好的治疗效果，特别对年轻患者效果更好些。（中华腰科杂志，2007，43：509-513）Objective To evaluate the effectiveness of photodynamic therapy （PDT） in the treatment of idiopathic choroidal neovascularization （CNV）. Methods Sixty-one cases （61 eyes） of CNV were treated with PDT and the fundus appearance, visual acuity, retina thickness as well as the fundus angiographic imaging were observed before and after the therapy. PDT was performed 1.2 times in average and the follow-up period was 6 -36 months （mean 19 months）. Results At the last follow up, the visual acuity was improved in 41 eyes （67. 2% ）, unchanged in 15 eyes （24. 6% ） and slightly decreased in 5 eyes （8. 2% ）. Macular hemorrhage and exudation reduced in all cases after PDT. Fundus angiography showed complete closure of CNV in 38 eyes （62. 3% ）, partial closure in 4 eyes （6. 6% ） , incomplete closure in 14 eyes （23.0%） and recurrence in 5 eyes（8. 2% ）. In 6 eyes CNV was complete closed after single PDT with diminish of macular edema and neuronal retinal epithelial detachment. No recurrent CNV was observed during three years＇ follow-up and the visual acuity remained stable. Our results also demonstrated that the therapeutic effect decreased with patient＇ s age （ t = 0. 476, P = 0. 016 ）. The decrease of visual acuity averaged 0. 008 per year. Conclusion Photodynamic therapy is a potential treatment for idiopathic CNV and better outcomes are achieved in younger patients. （Chin J Ophthalmol, 2007,43：509-513 ）

关 键 词：脉络膜视网膜炎 脉络膜新生血管化 光化学疗法 

分 类 号：R686[医药卫生—骨科学]