光动力疗法治疗息肉状脉络膜血管病变的临床观察  

Photodynamic therapy for polypoidal choroidal vasculopathy

作　　者：游江[1] 郭小健[1] 

机构地区：[1]中南大学湘雅二医院眼科,长沙410011

出　　处：《中南大学学报（医学版）》2011年第9期899-902,共4页Journal of Central South University ：Medical Science

摘　　要：目的:观察光动力疗法(PDT)治疗息肉状脉络膜血管病变(PCV)的治疗效果。方法:临床体征和病史结合荧光素眼底血管造影(FFA)、吲哚氰绿眼底血管造影(ICGA)及相干光断层扫描(OCT)确诊的11例(11只眼)息肉状脉络膜血管病变患者,应用PDT治疗并随访6～30个月,随访期间复查患者最佳矫正视力、眼底,进行FFA,ICGA,OCT检查。结果:PDT治疗后1个月,患者最佳矫正视力:3只眼保持不变,3只眼提高1行,2只眼提高2行,3只眼下降2行。FFA和ICGA检查显示5只眼的血管荧光素渗漏停止,3只眼渗漏减轻,3只眼有轻微渗漏。末次随访时,患者最佳矫正视力:5只眼保持不变,2只眼提高1行,2只眼提高2行,2只眼下降2行。FFA和ICGA检查显示6只眼的血管荧光素渗漏停止,3只眼渗漏减轻,2只眼仍有轻微渗漏。治疗后2个月时有1只眼并发玻璃体积血;未见其他全身及局部不良反应。结论:PDT能使PCV病灶渗漏停止或减轻,促进黄斑区出血、渗出及水肿的吸收,使患者视力稳定或改善,可作为治疗PCV的首选方法之一。Objective To determine the effect of photodynamic therapy （PDT） for polypoidal choroidal vasculopathy （PCV）. Methods Eleven patients （11 eyes） with PCV who were diagnosed by fundus fluorescein angiography （FFA）, indocyanine green angiography （ICGA） and optic coherence tomography （OCT） were given PDT. The changes of best corrected visual acuity（BCVA）, fundus photography, FFA and ICGA before and after the PDT were compared. Follow-up time varied from 6 to 30 months. Results One month after the PDT, the BCVA was stable in 3eyes, increased in 1 line in 3 eyes, increased in 2 lines in 2 eyes, and decreased in 2 lines in 3 eyes. FFA and ICGA showed no leakage in 5 eyes, leakage reduced in 3 eyes, and slight leakage in 3 eyes. At the last follow-up, the BCVA was stable in 5 eyes, increased in 1 line in 2 eyes, increased in 2 lines in 2 eyes, and decreased in 2 lines in 2 eyes. FFA and ICGA showed no leakage in 6 eyes, leakage reduced in 3 eyes, and slight leakage in 2 eyes. No severe systemic or local ad- verse effect was faired dlirlngor after the PDT aYaont that 1 eye had vltreous hemarrhage 2 months after the PDT. Conclusion PDT may stop or reduce leakage of the lesion, facilitate the absorption of hemorrhage, edema and exudates, and stabilize or increase the patients＇ visual acuity. It could be a choice for PCV.

关 键 词：脉络膜病变 光化学疗法 维替泊芬 

分 类 号：R773.4[医药卫生—眼科]