CAJ | 학술논문

目的：观察1/3常规剂量光敏剂维替泊芬联合光动力疗法（PDT）治疗急性中心性浆液性脉络膜视网膜病变（ CSC）的有效性和安全性。方法选取2011年10月-2012年10月沈阳医学院沈洲医院、中国医科大学第一临床学院、沈阳市第四人民医院确诊的急性CSC患者90例（90眼），均接受1/3常规剂量维替泊芬静脉推注（2 mg/m2），静脉推注开始5 min后接受波长689 nm激光照射83 s。治疗后1周和1、3、6个月随访，比较治疗前后最佳矫正视力（ BCVA）、视网膜下积液面积、黄斑中心凹视网膜厚度（ CFT），观察不良反应。结果治疗后较治疗前BCVA提高，视网膜下积液面积减少， CFT变薄（P＜0.05）。 BCVA、视网膜下积液面积、 CFT治疗前到治疗后1个月内明显好转，治疗后1个月到6个月基本稳定，无不良反应发生。结论1/3常规剂量光敏剂维替泊芬联合PDT治疗急性CSC能停止或减少脉络膜血管渗漏，促进视网膜解剖复位，改善症状，提高和稳定视力，无明显不良反应。
목적：관찰1/3상규제량광민제유체박분연합광동력요법（PDT）치료급성중심성장액성맥락막시망막병변（ CSC）적유효성화안전성。방법선취2011년10월-2012년10월침양의학원침주의원、중국의과대학제일림상학원、침양시제사인민의원학진적급성CSC환자90례（90안），균접수1/3상규제량유체박분정맥추주（2 mg/m2），정맥추주개시5 min후접수파장689 nm격광조사83 s。치료후1주화1、3、6개월수방，비교치료전후최가교정시력（ BCVA）、시망막하적액면적、황반중심요시망막후도（ CFT），관찰불량반응。결과치료후교치료전BCVA제고，시망막하적액면적감소， CFT변박（P＜0.05）。 BCVA、시망막하적액면적、 CFT치료전도치료후1개월내명현호전，치료후1개월도6개월기본은정，무불량반응발생。결론1/3상규제량광민제유체박분연합PDT치료급성CSC능정지혹감소맥락막혈관삼루，촉진시망막해부복위，개선증상，제고화은정시력，무명현불량반응。
ObjectiveToobservethetherapeuticeffectandsafetyofphotodynamictherapy(PDT)with1/3conven-tional-doseverteporfinonacutecentralserouschorioretinopathy(CSC).Methods 90patients(90eyes)whowerediagnosed as acute CSC in Shenzhou Hospital Affiliated to Shenyang Medical College , the First Affiliated Hospital of China Medical Univer-sity, and Shenyang Fourth People′s Hospital from October 2011 to October 2012, were selected as study subjects .All patients ac-cepted intravenous injection of 1/3 conventional-dose verteporfin (2 mg/m2 ), 5 min later, patients received laser irradiation (689 nm) for 83 s.The follow -up time point was 1 week, 1, 3, 6 months after treatment.The best corrected visual acuity (BCVA), area of subretinal fluid and central fovea thichness (CFT) were compared before and after treatment , and the adverse reactions were recorded .Results The BCVA after treatment was significantly higher than that before treatment , area of subretinal fluid after treatment was significantly smaller than that before treatment , CFT after treatment was significantly thinner than that be-fore treatment (all P<0.05) .The BCVA, area of subretinal fluid and CFT 1 month after treatment were much better those be-fore treatment, the BCVA and area of subretinal fluid and CFT kept stability from 1 month after treatment to 6 months after treat-ment, no adverse reaction occurred within this period .Conclusion PDT with 1/3 conventional-dose verteporfin for acute CSC could improve symptoms , improve and maintain visual acuity , prevent or reduce the leakage from choroidal vascular , promote anatomical reposition of retinal , and have no obvious adverse reactions .