维替泊芬光动力疗法治疗息肉状脉络膜血管病变的随访观察  

One-year outcomes of photodynamic therapy with verteporfin in polypoidal choroidal vasculopathy

作　　者：卢彦[1] 蓝育青[1] 于珊珊[2] 王梅[1] 胡玉新[1] 郭慧[1] 

机构地区：[1]中山大学附属孙逸仙纪念医院眼科,广州510120 [2]中山大学中山眼科中心,眼科学国家重点实验室

出　　处：《中国实用眼科杂志》2011年第8期838-841,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察维替泊芬光动力疗法（photodyrnamic therapy，PDT）对息肉状脉络膜血管病变（polypoidal choroidal vasculopathy，PCV）的1年治疗效果。方法9例（10只眼）经眼底彩照、荧光素眼底血管造影（fundus fluorescein angiography，FFA）和吲哚青绿血管造影（indocyanine green angiography，ICGA）确诊的PCV患者，进行常规的PDT治疗，治疗后随访第2周、1月、3月、6月、1年，观察治疗前后的视力、眼底彩照、FFA和（或）ICGA。结果PDT治疗后1年视力提高3只眼，视力稳定6只眼，1只眼PDT治疗后出血吸收第2月复发黄斑区出血视力下降；1只眼治疗后第2周出现严重视网膜下出血，随访后渐吸收，其余患眼底出血、渗出均吸收消失。第3个月造影检查渗漏停止7只眼，3只眼轻微渗漏，末次随访3只眼仍轻微渗漏。PDT治疗过程无一例出现严重全身并发症。结论PDT是一种安全有效的PCV治疗方法，可以短期内减轻或封闭异常血管的渗漏，促进出血、渗出吸收，稳定或提高患者视力，个别患者治疗后出现严重网膜下出血能自行吸收。Objective To observe prospectively one-year＇s effect of photodynamic therapy （PDT） with verteporfin in polypoidal choroidal vasculopathy （PCV）. Methods Nine patients （10 eyes） diagnosed as PCV according to fundus color, fundus fluorescein angiography （FFA） and indocyanine green angiography （ICGA） were performed PDT. Visual acuity, Fundus appearance, FFA and/or ICGA were compared before PDT, and then at 2 weeks, 1 month, 3 months, 6 months and 12 months after PDT. Results One year after the PDT, visual acuity was improved in 3 eyes and stabilized in 6 eyes. Visual acuity in one eye decreased again because of recurred macular bleeding. Massive subretinal hemor- rhage in one eye appeared two weeks after PDT and absorbed during the period of follow-up. The bleeding and exudates in the last 8 eyes were absorbed during the follow-up. At the 3 months, FFA and/or ICGA showed no leakage in 7 eyes, slight leakage in 3 eyes and still leakage at the final follow-up. No systemic adverse effect was. found during and after PDT. Coneluslons PDT offers an ef- fective and safe way of treating PCV. PDT may relieve or stop vascular leakage, promote the elimination of the retinal hemorrhage and exudates, improve or stable the visual acuity. Massive retinal hemorrhage after PDT appears and absorbs in individual patients.

关 键 词：黄斑变性 治疗 光化学疗法 治疗结果 

分 类 号：R773.4[医药卫生—眼科]