小剂量维替泊芬光动力疗法治疗急性中浆远期疗效观察  

Long-term results of photodynamic therapy with one third standard dose verteporfin for acute central serous chorioretinopathy （CSC）

作　　者：邹王凌 游志鹏[1] 

机构地区：[1]南昌市南昌大学第二附属医院眼科,江西省330006

出　　处：《中国实用眼科杂志》2014年第2期166-169,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨1／3剂量维替泊芬光动力疗法治疗急性中心性浆液性脉络膜视网膜病变（CSC）的远期疗效。方法临床病例对照研究。对2009年1月至2011年1月在南昌大学第二附属医院眼科结合患者病史和眼底检查、光学相干断层成像（OCT）、眼底荧光血管造影（FFA）及吲哚菁绿血管造影（ICGA）检查，诊断为急性CSC患者52例52只眼；A组32例采用1／3剂量维替泊芬光动力疗法（PDT）治疗，维替？白芬注入10min后，在吲哚菁绿的引导下激光照射83S；B组20例采用药物治疗（复方血栓通胶囊及维生素类）。随访16—38个月，平均27．2个月，两组进行最佳矫正视力、OCT、FFA和ICGA检查。结果A组患者在治疗后6个月至末次随访时所有患者最佳矫正视力得到提高，视物变形症状消失；治疗后OCT、FFA、ICGA检查，在3个月时100％显效，随后至末次随访时未见复发病例及与PDT治疗相关的眼部及全身不良反应。B组患者在末次随访时仅20％（4／20）例患者最佳矫正视力得到提高，视物变形症状消失，OCT、FFA、ICGA检查显效；70％（14／20）例以上患者最佳矫正视力下降，视物变形症状、OCT、FFA及ICGA检查无效，并且2例患者出现复发。结论1／3剂量维替泊芬PDT治疗急性CSC具有良好地远期疗效，但该治疗方法的安全性和有效性还有待于多中心大样本研究的进一步证实。Objective To observe the long-term results of photodynamic therapy with one third standard dose verteporfin for acute central serous chorioretinopathy （CSC）. Methods Fifty-two eyes of 52 patients diagnosed as acute CSC by the examination of fundus, optical coherence tomography （OCT）, fundus fluorescein angiography （FFA） and indocyanine green angiography （ICGA）; 32 pa- tients in group A underwent photodynamic therapy （PDT） with one third standard dose verteporfin by means of specific laser slit lamp; 20 patients in group B treated with medications, then followed up 16-38 months, meanly 27.2 months. During the time of follow-up, examinations included best corrected visual acuity （BCVA）, OCT, FFA and ICGA. Results In group A, the BCVA increased cu- riously and visual distortion symptoms disappeared in all patients from 6 months after PDT; the post- operative OCT, FFA, ICGA had regressed in all eyes （100%） after 3 months, there were no recur- rence and ocular and systemic complications until the final follow-up. In group B, only 20% of the patient＇s BCVA improved, visual distortion symptoms, OCT, FFA and ICGA showed significantly ef- fective while more than 70% of that showed invalid, and 2 patients relapsed at the last follow-up. Conclusions Photodynamic therapy with one third standard dose verteporfin for acute CSC has a good long-term result, but further multi-center clinical trial of a large sample study is warranted to demonstrate the safety and efficacy of the treatment.

关 键 词：急性中心性浆液性脉络膜视网膜病变 光动力疗法 维替泊芬 远期疗效 

分 类 号：R135.2[医药卫生—劳动卫生]