半剂量光动力疗法治疗中心性浆液性脉络膜视网膜病变观察  

Haft-dose verteporfin photodynamic therapy for central serous chorioretinopathy

作　　者：范银波[1] 肖云[1] 张改丽[1] 渠岚[1] 顾永欣[1] 张燕[1] 

机构地区：[1]解放军474医院眼科、全军眼科中心,乌鲁木齐830013

出　　处：《中国实用眼科杂志》2012年第2期193-195,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 观察半剂量光动力疗法治疗中心性浆液性脉络膜视网膜病变的疗效及安全性.方法 2008年4月至2010年9月在门诊确诊的中心性浆液性脉络膜视网膜病变患者24例24只眼,其中男20例20只眼,女4例4只眼,年龄27～48岁,平均36.8岁,最佳矫正视力0.2～0.5,平均0.42,行半剂量光动力疗法治疗,随访按照术后l周、1月、3月、6月、9月进行,随访时间3～8月,平均4.8月,随访期间分别行裂隙灯眼底镜检查、最佳矫正视力、OCT及FFA检查,观察治疗的有效性和安全性.结果 术后l周,OCT显示4只眼视网膜下积液吸收,19只眼视网膜下积液部分吸收,1只眼视网膜下积液无明显变化；术后1月,OCT显示18只眼视网膜下积液吸收,5只眼视网膜下积液部分吸收,1只眼视网膜下积液无明显变化；FFA显示19只眼荧光渗漏消失,4只眼渗漏减轻,1只眼渗漏无明显变化.术后3月,OCT最示23只眼视网膜下积液吸收,1只眼视网膜下积液部分吸收；FFA显示23只眼荧光渗漏消失,1只眼渗漏减轻.对渗漏未完全消失眼再次行半剂量光动力疗法,1月后OCT显示视网膜下积液吸收,FFA显示荧光渗漏消失呈荧光着染.末次随访时最佳矫正视力0.5～1.0,提高2行以上者19只眼.结论 半剂量光动力疗法治疗中心性浆液性脉络膜视网膜病变疗效显著,安全.Objective To observe the effect and security of photodynamic therapy with half-dose verteporfin for central serous chorioretinopathy （CSC）. Methods Twenty-four eyes of 24 patients diagnosed CSC by fundus examination,FFA and OCT.Photodynamic therapy with half-dose verteporfin were employed on leakage position according to ICGA.Laser treatment at a light intensity of 600mw/m2 and dose of 50J/cm2 and duration of 83 seconds were performed 15 minutes after verteporfin was infused.Patients were followed up for 3-9 months with visual acuity measurements,dilated ophthalmoscopy,FFA and OCT to observe the effect and security of treatment. Results One week after PDT,OCT showed that subretinal fluid of 4 eyes absorbed absolutely,of 19 eyes partly and 1 eye without any change.One month after PDT,OCT showed that subretinal fluid of 18 eyes absorbed absolutely,of 5 eyes partly and 1 eye without any change,FFA showed that fluorescence leakage of 19 eyes disappeared,of 4 eyes lessened and 1 eye without any change.Three months after PDT,OCT showed that subretinal fluid of 23 eyes absorbed absolutely,of 1 eye lessened.The one eye with fluorescence leaking accepted the second time PDT,one month after PDT,the subretinal fluid absorbed absolutely by OCT and leakage disappeared by FFA.The visual acuity of last follow up was 0.5-1.0,of 19 eyes elevated two rows. Conclusions It is effective and secure that photodynamic therapy with half-dose verteporfin treat central serous chorioretinopathy.

关 键 词：光动力疗法 中心性浆液性脉络膜视网膜病变 光学相干断层扫描 眼底荧光血管造影 

分 类 号：R774.1[医药卫生—眼科]