论文部分内容阅读
目的研究光动力疗法(PDT)治疗年龄相关性黄斑变性(AMD)、病理性近视(PM)和特发性脉络膜新生血管形成(CNV)三种国内常见CNV相关疾病的长期效果和安全性。设计回顾性病例系列。研究对象2005年6月至2007年12月西京医院眼科确诊的CNV患者91例(101眼)。方法患者经常规PDT治疗,治疗后每3个月进行复查,复发的患者再次行PDT治疗。观察治疗前与治疗后12、24个月时患者的最佳矫正视力(BCVA,ETDRS视力表)、荧光素眼底血管造影(FFA)图像上CNV病灶情况、治疗次数及不良事件等。患者治疗后均完成24个月随访。主要指标BCVA,CNV病灶大小和活动性。结果 AMD、PM和特发性CNV的平均治疗次数分别为1.50、1.38和1.19次。AMD组治疗后BCVA和CNV病灶大小均无明显变化,保持稳定;PM组和特发性CNV组视力提高(分别为7.0和7.7个字母,7.6和11.6个字母),并且CNV病灶缩小。三组病例视力稳定和提高者12个月时分别为77.1%、76.2%和87.5%;24个月时为79.2%、81.0%和87.5%。CNV进展者12个月时各组分别为18.8%、19.0%和12.5%;24个月时为14.6%、14.3%和6.2%。除3例(2.2%)AMD患者因玻璃体积血和视网膜色素上皮撕裂导致眼部严重不良反应外,未发现其他严重不良反应。结论在2年的随访期间,PDT可安全有效地改善或稳定我国临床常见CNV患者的视功能,控制病变进展。
Objective To investigate the long-term efficacy and safety of photodynamic therapy (PDT) in the treatment of three CNV-related diseases in China, including age-related macular degeneration (AMD), pathological myopia (PM) and idiopathic choroidal neovascularization (CNV). Design retrospective case series. Subjects 91 patients (101 eyes) with CNV diagnosed in Xijing Hospital from June 2005 to December 2007. Methods Patients were treated with PDT routinely and were reviewed every 3 months after treatment. Patients with recurrent PDT were treated again. The best corrected visual acuity (BCVA, ETDRS visual acuity chart), CNV lesions on fluorescein fundus angiography (FFA) images, the number of treatment and adverse events were observed before and 12, 24 months after treatment. Patients after treatment were completed 24 months follow-up. The main indicators BCVA, CNV lesion size and activity. Results The average number of treatments for AMD, PM and idiopathic CNV were 1.50, 1.38 and 1.19, respectively. There was no significant change in the size of BCVA and CNV lesions in AMD group after treatment, and visual acuity was improved in PM and idiopathic CNV patients (7.0 and 7.7 letters, 7.6 and 11.6 letters, respectively) and CNV lesions were reduced. The three groups were 77.1%, 76.2% and 87.5% at 12 months and 79.2%, 81.0% and 87.5% at 24 months, respectively. At 12 months, those with CNV progressed were 18.8%, 19.0% and 12.5% in each group, 14.6%, 14.3% and 6.2% at 24 months, respectively. No other serious adverse reactions were found except for 3 eyes (2.2%) of patients with AMD who developed severe ocular adverse reactions due to vitreous hemorrhage and retinal pigment epithelium tears. Conclusions During 2 years of follow-up, PDT can safely and effectively improve or stabilize the visual function of patients with common CNV in our country and control the progression of the disease.