光动力治疗脉络膜新生血管性疾病观察  

Clinical observation of photodynamic therapy for choroidal neovascularization disease

作　　者：喻青[1] 王鲜[1] 李志敏[1] 韩樱[1] 韩慧[1] 冯莉[1] 

机构地区：[1]贵阳医学院附属医院眼科,550001

出　　处：《中国实用眼科杂志》2013年第9期1158-1160,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察光动力疗法治疗脉络膜新生血管性疾病的临床疗效及安全性。方法回顾性分析2010年9月至2012年6月在贵阳医学院附属医院眼科门诊采用维替泊芬光动力疗法（PDT）治疗脉络膜新生血管性疾病50例65只眼的临床效果，比较PDT治疗前后的视力、CNV范围、光学相干断层成像（OCT）、荧光素血管造影（FFA）、吲哚青绿血管造影（ICGA）等图像资料。年龄相关性黄斑变性（AMD）35例50只眼；中心性渗出性脉络膜视网膜病变（CEC）5例5只眼；息肉状脉络膜血管病变（PCV）4例4只眼；病理性近视（PM）5例5只眼；外伤性脉络膜裂伤CNV1例1只眼。结果全组50例65只眼PDT治疗后随访观察6个月，视力稳定和提高的AMD30只眼（60．00％）、CEC4只眼（80．00％）、PCV2只眼（50．00％）、PM4只眼（80．00％）、脉络膜裂伤CNV1只眼（100％）；视力下降、CNV渗漏有进展的AMD20只眼（40．00％）、CEC1只眼（20．00％）、PCV2只眼（50．00％）、PM1只眼（20．00％）。经ICGA、FFA检查发现CNV复发的30例30只眼，重复治疗2次的10例10只眼，3次的3例3只跟。重复治疗时间：1个月者1例1只眼，3个月者8例8只眼，6个月者1例1只眼。所有病例均未见严重的不良反应。结论PDT对治疗继发于不同病因的黄斑CNV安全、有效，可以减轻CNV的渗漏，延缓视力下降，但治疗后仍有复发需反复治疗。Objective To evaluate the clinical efficacy and safety of photodynamic therapy （PDT） for choroidal neovascularization （CNV）. Methods A retrospective analysis from September 2010 to June 2012 using verteporfin photodynamic therapy （PDT） for treatment of choroidal neovas- cularization disease in 50 cases 65 eyes. Clinical effect, vision, CNV range, optical coherence tomog-raphy （OCT）, Fluorescein angiography （FFA）, indocyanine green angiography （ICGA） such as image PDT data before and after treatment were compared. Age-related macular degeneration （AMD） was 50 eyes in 35 cases; Central exudative chorioretinopathy （CEC） 5 eyes in 5 cases; Polypoidal choroi-dal vasculopathy （PCV） 4 eyes in 4 cases; pathologic myopia （PM） 5 eyes in 5 cases; Traumatic cho-roidal rupture CNV 1 eye in 1 case. Results Sixty-five eyes of 50 patients underwent PDT with 6 months follow-up. Visual Acuity （VA） kept stability and improved 30 eyes （69.76%） in AMD, 4 eyes （80.00%） in CEC, 2 eyes （50.00%） in PCV, 4 eyes （80.00%） in PM, 1 eye （100%） in choroid crack CNV. The CNV leakage was observed 20 eyes （46.51%） in AMD, 1 eye （20.00%） in CEC, 2 eyes （50.00%） in PCV, 1 eye （20.00%） in PM. There were 30 recurrence eyes in 30 cases according to ICGA, and FFA examination, including l0 eyes in l0 cases with the second time retreatment and 3 eyes in 3 cases with third time retreatment. There was difference from the period of retreatment： 1 eye in 1 case at the time of one month post treatment, 5 eyes in 5 cases 3 months after treatment, and 1 eye in 1 case post treatment. All cases were no occurred severe complications. Conclusions PDT is a safe and effective treatment for patients of CNV caused by different macular disease,which can reduce CNV leakage, delay visual acuity decrease, however still needs re-treatment.

关 键 词：光动力疗法 脉络膜新生血管 

分 类 号：R774.1[医药卫生—眼科]