摘要
目的利用光学相干断层扫描(OCT)观察光动力学治疗(PDT)黄斑脉络膜新生血管(CNV)前后CNV的组织形态变化,以评价PDT的疗效。方法回顾性分析从2004年5月至2005年6月在我院接受PDT治疗的各类CNV患者34例38眼,对治疗前后CNV的OCT形态特征进行评估和分类。结果PDT治疗后的OCT形态特征可分为5型。I型:急性炎症反应,有4眼,平均出现于PDT后26h;II型:黄斑中心凹结构基本恢复正常,视网膜下积液吸收,有38眼,平均出现于PDT后2.8w;III型:视网膜下积液重新出现伴纤维化,根据积液与纤维化程度又可分为IIIa/IIIb。IIIa:视网膜下积液为主,有8眼,平均出现时间为PDT后1.7m;IIIb:视网膜下纤维化30眼,平均出现时间PDT后1.9m;IV型:黄斑囊样水肿伴视网膜下纤维化有3眼,于PDT后平均4.9m出现。V型视网膜下纤维化伴萎缩有8眼,于PDT后平均8.1m出现。结论OCT可用于动态观察PDT后CNV的形态变化,根据分型可协助制订治疗方案,IIIa型代表CNV复发,可能需再次PDT治疗,而IIIb和IV型则可随访观察。
Objective To develop an optical coherence tomography （OCT） classification system to evaluate the response of eyes treated with photodynamic therapy with verteporfin for choroidal neovascularization. Methods The eyes treated with photodynamic therapy with verteporfm for choroidal neovascularization were retrospectively reviewed. Optical coherence tomography were performed before treatment and at subsequent follow-up examinations in all eyes. Optical coherence tomography findings were evaluated. Results A fivetype classification system was developed. Type Ⅰ： acute inflammatory with increased subretinal fluid; Type Ⅱ： restoration of near-normal fovea contour with diminished subretinal fluid; Type Ⅲ is subdivided into two categories based on the amount of subretinal fibrosis and fluid present. Ⅲ a contains a greater subretinal fluid to fibrosis; Ⅲ b have more prominent fibrosis with minimal intraretinal fluid, Type Ⅳ： cystoid macular edema. Type Ⅴ： thinning of retina with fibrosis. Conclusions Optical coherence tomography appears to be useful in monitoring the retinal changes that occur following PDT of CNV and may assist in making decisions for retreatments.
出处
《中国实用眼科杂志》
CSCD
北大核心
2006年第10期1018-1020,共3页
Chinese Journal of Practical Ophthalmology
