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目的观察光动力学治疗继发于不同病因的黄斑中心凹下或中心凹旁脉络膜新生血管的疗效和安全性。方法回顾16例16眼经荧光血管造影、吲哚青绿造影证实活动性脉络膜新生血管,继发于老年性黄斑变性4眼,病理性近视6眼和中心性渗出性脉络膜视网膜病变6眼。比较PDT治疗前后最佳矫正视力,散瞳前置镜眼底检查以及荧光血管造影和脉络膜血管造影的资料。典型性为主型CNV14眼,轻微典型性CNV1眼,隐匿性CNV1眼。CNV位于黄斑中心凹下12眼,黄斑中心凹旁4眼。光动力学治疗方案参照TAP制定的标准。结果随访时间:1~14个月,平均(5±4.28)个月。1次治疗14眼,重复治疗2次1眼,3次1眼。最终患眼视力提高8眼,保持不变8眼。FFA检查示CNV渗漏停止1眼,渗漏减少10眼,渗漏无明显减少5眼,渗漏面积较治疗前明显缩小(P<0.05)。CNV复发3眼。仅1例在输液时发生光敏剂渗漏,但未发生光敏反应。治疗后视网膜一过性出血增加3眼。结论光动力学治疗为继发于不同病因的黄斑中心凹下或中心凹旁CNV患者提供一种安全有效的治疗选择。部分患者治疗后短时间内复发,PDT治疗CNV的长期疗效有待进一步观察。
Objective To observe the efficacy and safety of photodynamic therapy secondary to choroidal neovascularization in the fovea or fovea of different etiologies. Methods 16 cases (16 eyes) were confirmed by fluorescein angiography, indocyanine green angiography confirmed active choroidal neovascularization, secondary to age-related macular degeneration (4 eyes), pathological myopia (6 eyes) and central exudative chorioretinopathy (6 eyes). Comparison of PDT before and after the best corrected visual acuity, mydriatic fundus fundus examination and fluorescence angiography and choroidal angiography data. Typical for the main CNV14 eyes, mild typical CNV1 eyes, occult CNV1 eyes. CNV is located in the fovea of the fovea 12, 4 fovea. Photodynamic therapy programs refer to TAP standards. Results The follow-up time ranged from 1 to 14 months with an average of (5 ± 4.28) months. 1 treatment 14 eyes, repeat treatment 2 times 1 eye, 3 times 1 eye. The final visual acuity increased by 8 eyes, remained unchanged in 8 eyes. FFA showed CNV leakage stopped 1, the leakage decreased 10 eyes, no significant reduction in leakage 5, the leakage area was significantly reduced compared with before treatment (P <0.05). CNV recurred 3 eyes. Only one case of photosensitizer leakage occurred during infusion, but no photosensitization. Retinal hemorrhage after treatment increased by 3 eyes. Conclusions Photodynamic therapy provides a safe and effective treatment for CNV patients with subfoveal or fovea secondary to different etiologies. Some patients relapse within a short period of time after treatment, long-term efficacy of PDT in the treatment of CNV remains to be further observed.