黄斑脉络膜新生血管的PDT与TTT疗效对比观察  

Short-term comparison ofphotodynamic and transpupillary therapy for choroidal neovascularization

作　　者：陈青山[1] 曾键[1] 谢秀英[1] 李志[1] 古洵清[1] 黄丽娜[1] 

机构地区：[1]深圳市眼科医院,深圳518001

出　　处：《中国实用眼科杂志》2009年第3期231-234,共4页Chinese Journal of Practical Ophthalmology

基　　金：基金项目：深圳市科技计划项目（200602098）

摘　　要：目的比较经瞳孔温热疗法（TTT）与光动力疗法（PDT）治疗黄斑脉络膜新生血管的疗效。方法对比分析渗出性老年黄斑变性（AMD），特发性脉络膜新生血管，病理性近视，眼底血管样条纹继发黄斑CNV97例101只眼治疗后1个月，3个月的矫正视力（BCVA），眼底荧光血管造影（FFA）。治疗前均检查BCVA、FFA、光学相干断层扫描（OCT），部分病例行吲哚青绿脉络膜血管造影（ICGA）。其中PDT治疗52例54只眼，TTT治疗45例47只眼。结果PDT与TTT治疗后1月、3月矫正视力比较，PDT治疗组提高2行及2行以上与TTT治疗组比较差异无统计学意义（x2=0．27，P〉0．05，X2=0．034，P〉0．05）。PDT治疗后1、3月视力提高或不变（稳定）分别有25只眼（46．2％），20只眼（37％），TTT治疗后1、3月视力提高或不变分别有14只眼（29．8％），16只眼（34％），治疗后1月两组比较差异有统计学意义（x2=3．96，P〈0．05），治疗后3月两组比较差异无统计学意义（x。=1．78，P〉0．05）。典型性或典型性为主性CNVPDT与，TTT治疗后矫正视力比较，治疗后1、3月PD个组分别有40％，54％，哪’治疗组分别有12．5％，12．5％PD个组视力提高2行或2行以上。两组比较差异有统计学意义（x2=7．57，P〈0．01，x2=4．14，P〈0．05）。隐匿性CNVPDT与TTT治疗后矫正视力比较，治疗后1、3个月，PDT与TTT组视力无提高。治疗后1月PDT治疗组视力不变2只眼，TTT组5只眼，两组比较差异无统计学意义（x2=1．67，P〉0．05）。治疗后3月两组视力均下降。PDT与rIT丌治疗后1、3月CNV渗漏比较，治疗后1月PDT治疗组控制或减轻CNV的荧光渗漏要好于TTT治疗组，两组比较差异有统计学意义（x2=6．64，P〈0．05。治疗后3月比较差异无统计学意义（x2=1．2，P〉0．05）。结论PDT对典型性或典型性为主CNV的治疗，随访短期内（1-3个月）在视力、及CObjective To compare the clinical results ofphotodynamic and transpupillary thermother- apy for macular diseases with choroidal neovascularization.Methods 97 cases （ 101 eyes ）with exudative AMD, idiopathic CNV,pathologic myopia and fundus steak second CNV were divided into PDT and TTT groups.52 cases （54eyes）were treated with PDT and 45 cases （47eyes）with TTT.BCVA, FFA, OCT and ICG were evalu- ated before and after treatment within one or three months.Results Visual acuity of PDT group and TTT group followed up lor3 months increased at least 2 lines was no difference（x2=0.27 ,P〉0.05 ,x2=0.034,P 〉0.05 ）. Visual acuity in 25 eyes （46.2%）,20 eyes （37%）ofPDT group and 14 eyes （29.8%）, 16eyes （34%）ofTTT group increased or unchanged.the difference was significant（x2= 3.96, P 〈0.05 ）followed 1 month.But the difference was no significant followed up 3 months.Visual acuity in 40%, 54% eyes with Classic CNV or predom- inantly CNV of PDT groups increased at 2 lines followed 1-3 months, however 12.5%, 12.5% in TTT groups. The difference was significant（x2= 7.57, P 〈0.01, x2= 4.14, P 〈0.05 ）o visual acuity of occult CNV no matter how PDT groups or TTT groups was no significant difference followed-up lto 3 months.FFA showed cessation or reduction of fluorescein leakage from CNV in PDT groups was better than TTT groups followed-up 1 month.（x2 = 6.64, P 〈 0.05 ）, there was no significant difference followed-up 3 months.Conclusion For classic CNV, the short-term effect of PDT is better than TTT concerning visual acuity.The effect of PDT is apparently better than TTT in cessation or reduction of fluorescin leakage 1 to 3 months after treatment.For occult CNV, there is no significant short-term difference between monoPDT and momoTTT concerning visual acuity.We need more cases and long follow-up to evaluate combined two kinds of treatments in treating CNV.

关 键 词：黄斑病变 脉络膜新生血管 光动力疗法 经瞳孔温热疗法 

分 类 号：R774.5[医药卫生—眼科] R587.2[医药卫生—临床医学]