摘要
渗出型老年性黄斑变性(wAMD)以脉络膜新生血管(CNV)的进行性生长为主要特征。抗血管内皮生长因子(VEGF)药物在控制CNV的发展和改善视功能中已取得一定成果,但其仍存在频繁注射、容易耐药等不足。放射治疗(放疗)可使局部炎症细胞群失效,CNV在无周细胞覆盖下不稳定且无VEGF存在,血管内皮细胞被诱导凋亡。因此,放疗被认为是抗VEGF治疗的一类潜在辅助治疗手段。目前临床试验治疗wAMD主要运用黄斑前近距离放疗和远距离立体定向放疗(SRT)。其中,SRT或许可作为接受抗VEGF治疗患者的首选辅助治疗方式。了解放疗用于wAMD治疗的进展,可为wAMD的临床研究提供参考。
Exudative or wet age-related macular degeneration (AMD) is characterized by the progressive growth of choroidal neovascularization (CNV). Anti-vascular endothelial growth factor (VEGF) drugs have been used in the control of the development of CNV and vision improvement, but there are still defects like frequent injections, drug resistance and so on. Radiotherapy can deactivate local inflammatory cell populations, and make CNV unstable in the absence of pericytes and VEGF stimulation, which induce apoptosis of the vascular endothelial cells. Therefore, radiotherapy is considered as a potential adjuvant treatment of anti-VEGF therapy. The current clinical approaches include epimacular brachytherapy (EMBT) and long-range stereotactic radiotherapy (SRT). SRT may be a preferred adjuvant treatment for patients receiving anti-VEGF therapy. Knowing the progress of radiotherapy for the treatment of exudative AMD may help us to fully understand the pathogenesis of wAMD in China
出处
《中华眼底病杂志》
CSCD
北大核心
2017年第6期652-655,共4页
Chinese Journal of Ocular Fundus Diseases
基金
国家自然科学杰出青年基金(81425006)
上海交通大学医学院转化医学创新基金(15ZH2009)