国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2014年
7期
1212-1215
,共4页
光动力%玻璃体腔%ranibizumab%病理性近视%脉络膜新生血管
光動力%玻璃體腔%ranibizumab%病理性近視%脈絡膜新生血管
광동력%파리체강%ranibizumab%병이성근시%맥락막신생혈관
photodynamic%intravitreal%ranibizumab%pathologic myopia%choroidal neovascularization
目的：评价光动力疗法( photodynamic therapy,PDT)联合玻璃体腔注射 ranibizumab 治疗病理性近视( pathologic myopia,PM )所致的黄斑部脉络膜新生血管( choroidal neovascularization,CNV)的临床疗效。<br> 方法：临床确诊为PM合并CNV患者32例32眼,随机选取16例16眼为PDT治疗( PDT组),另16例16眼为PDT联合玻璃体腔注射ranibizumab治疗组(联合组),两组黄斑水肿无显著性差异。对比分析治疗前及治疗后1,6 mo患者最佳矫正视力( best corrected visual acuity,BCVA)、光学相干断层扫描( optic coherence tomograph,OCT)及眼底荧光血管造影( fundus fluorescein angiography,FFA)的变化。结果：治疗后1 mo与治疗前相比：PDT组BCVA平均值提高,黄斑中心厚度( fovea centralis thickness, CMT )平均值降低,差异具有统计学意义( P<0.05)；联合组BCVA平均值明显提高,CMT平均值明显降低,差异具有显著统计学意义( P<0.01)；两组组间比较BCVA变化、CMT变化差异具有统计学意义(P<0.05)。治疗后6mo与治疗前相比, PDT组BCVA平均值提高,CMT平均值降低,差异具有统计学意义(P<0.05)；联合组BCVA平均值明显提高,CMT 平均值明显降低,差异具有显著统计学意义( P<0.01)；两组组间比较BCVA变化、CMT变化差异具有统计学意义( P<0.05)。治疗后6 mo 和1 mo 相比：PDT 组与联合组BCVA平均值、CMT 平均值差异均无统计学意义( P>0.05)。 FFA检查显示：治疗后1mo,PDT组 CNV病灶渗漏停止或渗漏减少者11眼(69%),持续渗漏5眼(31%)；联合治疗组 CNV病灶渗漏停止或渗漏减少者13眼(81%),持续渗漏3眼(19%)。治疗后6 mo：PDT 组CNV病灶渗漏停止或渗漏减少者10眼(62.5%),持续渗漏4眼(25%),2眼(12.5%)出现渗漏复发；联合治疗组CNV病灶渗漏停止或渗漏减少者15眼(94%),持续渗漏1眼(6%)。<br> 结论：PDT治疗与PDT联合玻璃体腔注射ranibizumab治疗均可以部分或完全封闭PM所致的CNV,减少CNV引起的视力下降；联合治疗的效果及稳定性要优于单纯的PDT治疗。
目的：評價光動力療法( photodynamic therapy,PDT)聯閤玻璃體腔註射 ranibizumab 治療病理性近視( pathologic myopia,PM )所緻的黃斑部脈絡膜新生血管( choroidal neovascularization,CNV)的臨床療效。<br> 方法：臨床確診為PM閤併CNV患者32例32眼,隨機選取16例16眼為PDT治療( PDT組),另16例16眼為PDT聯閤玻璃體腔註射ranibizumab治療組(聯閤組),兩組黃斑水腫無顯著性差異。對比分析治療前及治療後1,6 mo患者最佳矯正視力( best corrected visual acuity,BCVA)、光學相榦斷層掃描( optic coherence tomograph,OCT)及眼底熒光血管造影( fundus fluorescein angiography,FFA)的變化。結果：治療後1 mo與治療前相比：PDT組BCVA平均值提高,黃斑中心厚度( fovea centralis thickness, CMT )平均值降低,差異具有統計學意義( P<0.05)；聯閤組BCVA平均值明顯提高,CMT平均值明顯降低,差異具有顯著統計學意義( P<0.01)；兩組組間比較BCVA變化、CMT變化差異具有統計學意義(P<0.05)。治療後6mo與治療前相比, PDT組BCVA平均值提高,CMT平均值降低,差異具有統計學意義(P<0.05)；聯閤組BCVA平均值明顯提高,CMT 平均值明顯降低,差異具有顯著統計學意義( P<0.01)；兩組組間比較BCVA變化、CMT變化差異具有統計學意義( P<0.05)。治療後6 mo 和1 mo 相比：PDT 組與聯閤組BCVA平均值、CMT 平均值差異均無統計學意義( P>0.05)。 FFA檢查顯示：治療後1mo,PDT組 CNV病竈滲漏停止或滲漏減少者11眼(69%),持續滲漏5眼(31%)；聯閤治療組 CNV病竈滲漏停止或滲漏減少者13眼(81%),持續滲漏3眼(19%)。治療後6 mo：PDT 組CNV病竈滲漏停止或滲漏減少者10眼(62.5%),持續滲漏4眼(25%),2眼(12.5%)齣現滲漏複髮；聯閤治療組CNV病竈滲漏停止或滲漏減少者15眼(94%),持續滲漏1眼(6%)。<br> 結論：PDT治療與PDT聯閤玻璃體腔註射ranibizumab治療均可以部分或完全封閉PM所緻的CNV,減少CNV引起的視力下降；聯閤治療的效果及穩定性要優于單純的PDT治療。
목적：평개광동력요법( photodynamic therapy,PDT)연합파리체강주사 ranibizumab 치료병이성근시( pathologic myopia,PM )소치적황반부맥락막신생혈관( choroidal neovascularization,CNV)적림상료효。<br> 방법：림상학진위PM합병CNV환자32례32안,수궤선취16례16안위PDT치료( PDT조),령16례16안위PDT연합파리체강주사ranibizumab치료조(연합조),량조황반수종무현저성차이。대비분석치료전급치료후1,6 mo환자최가교정시력( best corrected visual acuity,BCVA)、광학상간단층소묘( optic coherence tomograph,OCT)급안저형광혈관조영( fundus fluorescein angiography,FFA)적변화。결과：치료후1 mo여치료전상비：PDT조BCVA평균치제고,황반중심후도( fovea centralis thickness, CMT )평균치강저,차이구유통계학의의( P<0.05)；연합조BCVA평균치명현제고,CMT평균치명현강저,차이구유현저통계학의의( P<0.01)；량조조간비교BCVA변화、CMT변화차이구유통계학의의(P<0.05)。치료후6mo여치료전상비, PDT조BCVA평균치제고,CMT평균치강저,차이구유통계학의의(P<0.05)；연합조BCVA평균치명현제고,CMT 평균치명현강저,차이구유현저통계학의의( P<0.01)；량조조간비교BCVA변화、CMT변화차이구유통계학의의( P<0.05)。치료후6 mo 화1 mo 상비：PDT 조여연합조BCVA평균치、CMT 평균치차이균무통계학의의( P>0.05)。 FFA검사현시：치료후1mo,PDT조 CNV병조삼루정지혹삼루감소자11안(69%),지속삼루5안(31%)；연합치료조 CNV병조삼루정지혹삼루감소자13안(81%),지속삼루3안(19%)。치료후6 mo：PDT 조CNV병조삼루정지혹삼루감소자10안(62.5%),지속삼루4안(25%),2안(12.5%)출현삼루복발；연합치료조CNV병조삼루정지혹삼루감소자15안(94%),지속삼루1안(6%)。<br> 결론：PDT치료여PDT연합파리체강주사ranibizumab치료균가이부분혹완전봉폐PM소치적CNV,감소CNV인기적시력하강；연합치료적효과급은정성요우우단순적PDT치료。
AlM: To investigate the efficacy of photodynamic therapy ( PDT) and intravitreal injection with ranibizumab on macular choroidal neovascularization ( CNV ) of pathologic myopia ( PM) . <br> METHODS: There were patients ( 32 eyes ) who were diagnosed as PM with CNV. Randomly selected 16 cases ( 16 eyes ) which were given the PDT treatment ( PDT group ) . The remaining were given both PDT and intravitreal injection with ranibizumab ( combination group) . There is no significant difference on macular edema between two groups. We analyzed the changes in the best corrected visual activity ( BCVA) , optic coherence tomograph ( OCT ) and fundus fluorescein angiography (FFA) before and 1, 6mo after treatment. <br> RESULTS:One month after the treatment in PDT group:the BCVA increased while the CMT decreased compared with that of pretreatment (P<0. 05). One month after the treatment in combination group: the BCVA increased while the CMT decreased significantly compared with that of pretreatment (P<0. 01);the changes of BCVA and CMT showed statistically significant between the two groups ( P<0. 05). Six month after the treatment in PDT group: the BCVA increased while the CMT decreased compared with that of pretreatment ( P <0. 05 ). Six month after the treatment in combination group: the BCVA increased while the CMT decreased significantly compared with that of pretreatment ( P <0. 01 ); compared with changes of BCVA and CMT in two groups, the difference was significant after treatment (P<0. 05). Compared 1mo with 6mo after treatment:there was no significant difference in the BCVA and CMT changes (P>0. 05). One month after treatment: in PDT group, FFA showed no leakage or reduced leakage of CNV in 11 eyes (69%), and the fundus remained leaky in 5 eyes ( 31%); in combination group, FFA showed no leakage or reduced leakage of CNV in 13 eyes (81%);the fundus remained leaky in 3 eyes (19%). Six month after treatment:in PDT group, FFA showed no leakage or reduced leakage in 10 eyes ( 62. 5%); the fundus remained leaky in 4 eyes ( 25%); two eyes ( 12. 5%) relapsed leakage; in combination group, FFA showed no leakage or reduced leakage of CNV in 15 eyes (94%);the fundus remained leaky in 1 eye (6%). <br> CONCLUSlON: Not only PDT but also PDT and intravitreal injection with ranibizumab can block CNV of pathologic myopia completely or partly, and reduce the danger causing descent of vision. Effects and the stability of the combination therapy is superior to PDT treatment.
