光动力疗法治疗中心凹下脉络膜新生血管疗效观察  

Effect of photodynamic therapy on subfoveal choroidal neovascular membranes

作　　者：闫爱珍[1] 常欣[1] 

机构地区：[1]山西省眼科医院,太原030002

出　　处：《临床眼科杂志》2009年第3期206-208,共3页Journal of Clinical Ophthalmology

摘　　要：目的观察光动力疗法(PDT)治疗中心凹下脉络膜新生血管(CNV)的临床疗效及安全性。方法回顾分析经荧光素眼底血管造影(FFA),个别行吲哚氰绿血管造影(ICGA)和相干光断层成像术(OCT)等检查,确诊为中心凹下CNV29例(30只眼)进行PDT治疗。对其治疗前后的视力、FFA、OCT检查结果进行对比分析,评价PDT对中心凹下CNV的治疗效果。结果末诊视力提高10只眼占33%,稳定或不变者17只眼占57%,视力下降3只眼占10%。影像检查:FFA显示11只眼CNV无明显渗遍,OCT表现视网膜水肿吸收或减少,CNV反光团缩小并瘢痕化,16只眼渗遍减少,OCT检查强反射带变窄。3只眼渗遍增加,OCT检查视网膜色素上皮(RPE)-脉络膜毛细血管层强反光团扩大,神经上皮再次水肿增厚,伴有视网膜层间出血。30只眼其中28只眼进行1次治疗,2只眼进行了2次治疗。结论PDT治疗中心凹下CNV对早期,病灶范围小的患者大多数是安全有效的。Objective To observe the effect and safety of photodynamic therapy （PDT） on subfoveal choroidal neovascular membranes （CNV）. Methods A retrospective review of 29 patients （30eyes） who had subfoveal CNV approved by fluorescein fundus angiography （FFA）, indeeyanine green angiography （ICGA） or optical coherence tomography （OCT）. Comparison of visual acuity （ VA}. FFA and OCT before PDT treatment and after PDT treatment were performed to determine the effect of PDT treatment on subfoveal CNV. Results After PDT treatment there were three eyes （33%） with betterVA than before,17 eyes with VA（57%） and 3eyes with worse VA（ 10% ）. There were eleven eyes with slight fluoreseein leakage showed by FFA , those retinal edema had been either totally absorbed or partly reduced and the CNV became smaller and scared approved by OCT. Sixteen eyes performed decrease of fluorescein leakage in FFA and narrowed in area of CNV in OCT after PDT treatment. There were three eyes had been found the increase offluorescein leakage in FFA and enlarged of reflection of choroidal capillary layer, thickened in layer of optieal nerve fiber because of edema and haemorrhage between the layers of retina in OCT investigation. Among thirty eyes, there were twenty eight eyes underwent once treatment ,and two eyes twice treatment. Conclusion The photodynamie therapy for early staye and small area subfoveal ehoroidal neovascular membranes is efficacy and safety.

关 键 词：PDT 中心凹 脉络膜新生血管 

分 类 号：R773.4[医药卫生—眼科] R749.3[医药卫生—临床医学]