玻璃体腔注射曲安奈德联合光动力疗法治疗高度近视脉络膜新生血管疗效观察  

Intravitreal injection of triamcinolone acetonide combined photodynamic therapy for choroidal neovascularization in high myopia efficacy

作　　者：葛建杰[1] 高夕宁[1] 王沫学[1] 

机构地区：[1]山东省威海市文登中心医院,威海市264400

出　　处：《中国实用眼科杂志》2011年第10期1060-1063,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察玻璃体腔注射曲安奈德（triamcinolone acetonideTA）联合光动力疗法治疗高度近视脉络膜新生血管的临床疗效。方法依据病史、年龄、症状及经视力、眼底检查、眼底彩色照相、荧光素眼底血管造影（FFA）、光相干断层扫描（OCT），确诊为高度近视脉络膜新生血管（CNV）的患者153例165只眼，随机分为A、B、C组，A组51例58只眼、B组51例54只眼、C组51例53只眼。A组采用玻璃体腔注射TA联合光动力疗法。B组采用单纯光动力疗法（PDT）。C组采用单纯玻璃体腔注射TA的治疗方法。治疗后3、6个月随访。结果末次随访时，矫正视力0．01—1．2。A组：51例58只眼中治愈25只眼占43．10％；好转27只眼47．37％；无效6只眼9．53％；总有效率90．47％；复发3只眼5．17％。B组51例54只眼中治愈9只眼16．67％；好转15只眼27．78％；无效30只眼55．55％；总有效率44．45％；复发13只眼24．07％。C组51例53只眼中治愈10眼18．88％；好转14只眼26．41％；无效29只眼54．71％；总有效率45．29％；复发14只眼26．41％。三组总有效率比较差异有统计学意义（u=2．05693P〈0．05）。结论玻璃体腔注射TA联合光动力疗法治疗高度近视脉络膜新生血管疗效好，安全性高。解决了单一治疗中存在的诸多并发症及高复发率的难题。Objective To observe the clinical efficacy of intravitreal injection of triamcinolone acetonide （TA） combined photodynamic therapy （PDT） of choroidal revascularization （CNV） in high myopia. Methods Based on history, age, symptoms and by visual acuity, fundus examination, fundus photography, fundus fluorescein angiography （FFA）, optical coherence tomography （OCT）, high myopia diagnosed with choroidal neovascularization （CNV） of 153 patients （165 eyes） were randomly divided into group A, B and C. group A consisted of 51 cases （58 eyes）, group B 51 cases （54 eyes）, group C of 51 cases （53 eyes）. Group A treated with intravitreal injection of TA combined with photodynamic therapy, group B with photodynamic therapy alone （PDT）, group C with intravitreal injection of TA alone. All cases were follow-up 3, 6 months after treatment. Results At the final follow up, corrected visual acuity was 0.01-1.2. In group A, 58 eyes of 51 patients accounted for 43.10% cured in 25 eyes, improved 27 for 47.37%, invalid 6 for 9.53%, the total effective rate 90.47%, 5.17% recurrence in 3 eyes. In group B, 51 patients were cured 9 out of 54 eyes for 16.67%, 27.78% improvement in 15 eyes, 55.55% invalid in 30 eyes, total effective rate of 44.45%, recurrence 13 24.07%. In group C, 53 eyes of 51 patients were cured in 10 eyes 18.88%, improved 14 eyes 26.41%, invalid 29 eyes 54.71%, total effective rate of 45.29%, recurrence 14 26.41%. The total efficiency of the three groups had statistically significant difference （u =2.05693, P 〈0.05）. Conclusions Intravitreous injection of TA combined photodynamic therapy for choroidal neovascularization in high myopia is effective and safe. It solves the problems that a single treatment exist many complications and high recurrence rate.

关 键 词：脉络膜新生血管化/药物疗法 近视 退行性/药物疗法 光化学疗法/方法 曲安奈德/ 治疗应用 

分 类 号：R774.5[医药卫生—眼科]