摘要
目的分析改变参数光动力疗法治疗黄斑区脉络膜新生血管性疾病的短期疗效。方法9例(12只眼)脉络膜新生血管患者进行改变参数光动力疗法治疗。改变的参数包括:(1)药物静脉推注时间,由标准的10min缩短至5min以内;(2)激光照射时间,由标准的83s减至42s;余治疗参数不变。治疗后3个月内随访患者糖尿病性视网膜病变早期治疗研究(ETDRS)视力表最佳矫正视力、眼部裂隙灯检查情况,并在治疗后3个月行眼底血管荧光造影(fun-dus fluorescein angiography,FFA)、光学相干断层扫描(optical coherence tomography,OCT)等检查。结果在治疗后3d12只眼(100.0%)均未出现视力下降,其中4只眼ETDRS视力提高接近或大于3行;治疗后3个月11只眼(91.7%)视力保持稳定或提高,1只眼视力下降3行。全部患眼中,7只眼(58.3%)在治疗后3个月复查FFA和(或)OCT检查呈现较治疗前好转改变。5只眼治疗前为边界清楚的典型性病灶。治疗后3个月复查FFA,2只眼造影晚期荧光渗漏停止,1只眼荧光渗漏减少,2只眼仍见荧光渗漏;5只眼为轻微典型性及隐匿性病灶,2只眼治疗前有视网膜色素上皮脱离,治疗后3个月均明显好转;2只眼为近瘢痕期病灶,治疗前已伴有广泛视网膜色素上皮纤维血管化形成的病灶,治疗后FFA检查无明显改变。结论光动力疗法缩短静脉给药时间及局部激光照射时间,治疗后短期内患者视力下降较少出现,可能对视网膜色素上皮脱离患者有较好治疗作用,但能否对新生血管起到抑制作用仍不十分明确。
Objective To study the short-term effectiveness of verteporfin-photodynamic therapy （PDT） with changed parameter for choroidal neovaseularization （CNV） diseases.Methods Nine patients （ 12 eyes） were included in our study, changed treatment parameters included decreasing intravenous injection time from original 10 minutes to less than 5 minutes and reducing laser irradiation time from original 83 seconds to 42 seconds. Other parameters kept unchanged. Patients were required to be reexamined with best corrected ETDRS （early treatment diabetic retinopathy study） visual acuity, ophthalmic examinations in 3 days and 3 months after therapy and fundus fluorescein angiography （FFA） and/or optical coherence tomography （OCT） 3 months after therapy. Results The ETDRS visual acuity improved or kept unchanged in all 12 eyes （ 100% ） 3 days after treatment. The vision even improved nearly or above 3 lines in 4 eyes. The visual acuity improved or kept unchanged in 11 eyes （91.7%） 3 months after treatment, and decreased 3 lines and 1 eye. The FFA and/or OCT showed improved in 7 eyes （58.3%）. FFA showed well-defined CNV lesion before therapy in 5 eyes. Two lesions of the 5 eyes showed absence of leakage in late phase, 1 showed less leakage and 2 eyes continued leakage. Five eyes showed sub-pigment epithelial lesion presumed to be CNV yet lack typical definite lesion. Two lesions with retinal pigmented epithelial detachment （PED） showed lesser fluorescein staining and pooling. Two lesions were approximate cicatrization and showed little change after therapy. Conclusions Changed parameters therapy might maintain or improve the short-term visual acuity in choroidal neovaseularization diseases and might treat the retinal pigment epithelium detachment. But the effect on the CNV lesion is not quite sure.
出处
《中国激光医学杂志》
CAS
CSCD
2009年第4期209-212,269,270,共6页
Chinese Journal of Laser Medicine & Surgery
基金
广东省科技攻关基金资助项目(2008B080703062)
关键词
光动力疗法
治疗参数
脉络膜新生血管
Photodynamic therapy
Treatment parameter
Choroidal neovascularization
