光动力疗法治疗病理性近视脉络膜新生血管20例疗效观察  

Therapeutic effect of photodynamic therapy on choroidal neovascularization of pathological myopia

作　　者：干雪梅[1] 邓雪莲[1] 贺翔鸽[1] 刘少章[1] 张咏梅[1] 王原[1] 

机构地区：[1]第三军医大学大坪医院眼科野战外科研究所,重庆400042

出　　处：《重庆医学》2008年第24期2813-2814,2816,共3页Chongqing medicine

摘　　要：目的观察光动力疗法photodynamic therapy（PDT）对病理性近视患者pathological myopia（PM）脉络膜新生血管choroidal neovascularization（CNV）单次和多次治疗的疗效。方法回顾确诊为PMCNV的20例（26眼）其中女性24只眼，男性2只眼。进行PDT治疗的疗效。PDT治疗后7d、1个月、3个月、6个月、1年复查。复查FFA显示病灶范围扩大或渗漏增加者重复PDT治疗。结果一般水平分析：显示PDT治疗后视力明显提高，治疗前后视力差异有统计学意义。回归分析显示：（1）女性治疗视力提高的效果不如男性；（2）年龄大的治疗治疗后视力提高效果较差。PDT治疗后复查眼底所见：眼底出血和渗出减轻，FFA检查显示：CNV渗漏明显减少或完全停止。OCT提示CNV周围视网膜脉络膜水肿及神经上皮脱离明显好转。半年后如有CNV复发或扩大者经2～3次PDT后，渗漏逐渐减少。结论单次或重复PDT治疗可以部分或完全封闭脉络膜的CNV，减少CNV引起的视力下降的危险性，PDT治疗不影响病灶周围的视网膜和脉络膜组织。Objective To investigate the efficacy of single or multiple photodynamic therapy（PDT） on choroidal neovascularization （CNV） of pathological myopia（PM）. Methods The clinical data of 20 PM patients （28 eyes） treated with PDT were retro spectively analyzed. The PM patients were rechecked on 7d, 1 month, 3 month, 6 month and 1 year after PDT. The patients with lesion enlargement or leakage increase showed by FFA were treated with PDT again. Results After therapy, the visual acuity increased with statistical significance. The regression analysis showed that the male visual acuity was better than female after thera py,and the young was better than the old. After PDT,there were 11 eyes with significant improvement of the sight, 17 eyes were stable,nobody decreased in sight. The hemorrhage and exudation lessened in all patients. FFA showed that the exudation of CNV lessen significantly or stop completely. OCT indicated that edema of retina and choroid and sublation of neurepithelium around CNV improved significantly. The exudation lessened gradually after 2 3 times of PDT in the patients with CNV recurrence or lesion enlargement after half of a year. Conclusion Single or repeating PDT can block CNV completely or partly,and reduce the danger causing descent of vision. The PDT has no influence on retina and choroid around lesion.

关 键 词：光动力疗法 病理性近视 脉络膜新生血管 

分 类 号：R778.11[医药卫生—眼科] R454.2[医药卫生—临床医学]