摘要
目的 比较经瞳孔温热疗法 (TTT)和光动力疗法 (PDT)治疗渗出型老年性黄斑变性(AMD)脉络膜新生血管 (CNV)的疗效。 方法 对比分析渗出性 AMD患者行 PDT治疗的 35例 4 2只眼、TTT治疗的 35例 4 0只眼治疗前和治疗后 3个月的临床资料。所有患者治疗前后均进行视力、荧光素眼底血管造影 (FFA)、吲哚青绿血管造影 (ICGA)和光相干断层扫描 (OCT)检查。CNV类型均为黄斑中心凹下型或旁中心凹型。其中 ,隐匿性或隐匿性为主型的 CNV4 4只眼 ,典型性及典型性为主型的 CNV38只眼。PDT治疗的 4 2只眼中 ,隐匿性或隐匿性为主型 CNV19只眼 ,典型性或典型性为主型 CNV2 3眼 ;TTT治疗的 4 0只眼中 ,隐匿性或隐匿性为主型 CNV2 5只眼 ,典型性及典型性为主型 CNV15只眼。 结果 典型性或典型性为主型 CNV治疗后 1、3个月时 ,PDT组分别有 4 7.8%、4 3.5 %的患眼视力提高 2行以上 ;TTT组分别有 6 .7%、6 .7%的患眼视力提高 2行以上。两组之间治疗后 1、3个月时视力提高的比例比较 ,差异均有显著性的意义 (χ2 =7.118,P=0 .0 0 76 ;χ2 =5 .5 0 0 ,P=0 .0 190 )。 PDT组分别有 10 0 %、6 9.6 %的患眼 CNV荧光素渗漏停止或改善 ;TTT组分别有 5 3.2 %、80 .0 %的患眼 CNV荧光素渗漏停止或改善。两组之间治疗后 1个月时
Objective To compare the clinical results of photodynamic therapy(PDT) and transpupillary thermotherapy (TTT) for patients with choroidal neovascularization caused by exudative age-related macular degeneration. Methods Seventy cases (82 eyes) with exudative AMD were divided into PDT and TTT groups. Thirty-five cases (42 eyes) were treated with PDT. Nineteen eyes had occult or predominantly occult CNV. Twenty-three eyes had classic or predominantly classic CNV. Thirty-five cases (40 eyes) were treated with TTT. Twenty-five eyes had occult or predominantly occult CNV. Fifteen eyes had classic or predominantly classic CNV. Visual acuity, FFA, ICGA and OCT were evaluated before and after treatment. All cases were subfoveal or juxtafoveal CNV. The follow-up was (3-6 months.) Results Visual acuity in 3 eyes (15.8%) of PDT group and 1 eye (4.0%) in TTT group increased at least 2 lines. The difference was no significant(P=0.1778), FFA showed cessation or reduction of fluorescein leakage from CNV in 15 eyes(78.9%) in PDT group and 13 eyes(52.0%) in TTT group. The difference was not significant (P=0.0657). Three months after treatment, The visual acuity of 2 eyes(10.5%) in PDT group and 2 eyes (8.0%) in TTT group increased at least 2 lines. The difference was not significant (P=0.7728). FFA showed cessation or reduction of fluorescein leakage from CNV in 8 eyes(42.1%) in PDT group and 21 eyes(84.0%) in TTT group. The difference was significant (P=0.0037). Conclusion For classic CNV, the short-term effect of PDT is better than TTT concerning visual acuity. The effect of PDT is apparently better than TTT in cessation or reduction of fluorescein leakage one month after treatment. But there was no significant difference between PDT and TTT in cessation or reduction of fluorescein leakage three month after treatment. For occult CNV, there is no significant short-term difference between PDT and TTT concerning visual acuity. There was no significant difference between PDT and TTT in cessatin or reduction of fluoresce
出处
《中华眼底病杂志》
CAS
CSCD
2004年第5期285-288,共4页
Chinese Journal of Ocular Fundus Diseases
