CAJ | 학술논문

目的观察单独光动力疗法(PDT)及单次PDT联合玻璃体腔注射Avastin治疗病理性近视(PM)脉络膜新生血管(CNV)的疗效.方法回顾性系列病例研究.经荧光素眼底血管造影(FFA)/吲哚青绿血管造影(ICGA)及光学相干断层扫描(OCT)确诊为PM继发黄斑区CNV,且CNV处于活动期患者38例(38眼)纳入本研究.非随机分组行单独PDT及单次PDT联合玻璃体腔注射Avastin治疗,其中单独PDT治疗组21例(21眼),单次PDT联合玻璃体腔注射Avastin治疗组17例(17眼).治疗前利用糖尿病视网膜病变早期治疗研究(ETDRS)视力表检查患者可读取的字母数,微视野计(MP-1)检查黄斑区中心20°平均光敏感度(MS),OCT测量黄斑中心凹视网膜神经上皮层厚度.治疗后1、3、6个月随访,检查眼底并对比两组治疗前后及两组之间可读取字母数、黄斑中心凹神经上皮层厚度及MS值.若CNV再次渗漏,则需重复治疗.采用独立样本t检验及配对t检验进行分析.结果治疗后6个月,单独PDT治疗组及单次PDT联合玻璃体腔注射Avastin治疗组可读取字母数、黄斑中心凹视网膜厚度及MS较治疗前有显著改善,差异有统计学意义(单独PDT治疗组:=-4.45、10.72、-8.62,P＜0.01;单次PDT联合玻璃体腔注射Avastin治疗组:t=-9.28、8.72、-11.54,P＜0.01).治疗后1、3、6个月,两治疗组间可读取字母数及黄斑中心凹视网膜厚度比较差异无统计学意义(P＞0.05);单次PDT联合玻璃体腔注射Avastin治疗组MS值高于单独PDT治疗组,差异有统计学意义(t=-2.86、-2.15、-2.50,P＜0.05).结论单次PDT联合玻璃体腔注射Avastin治疗较单独PDT治疗能稳定、改善PM性CNV患者视网膜敏感度,但需随机、大样本研究证实.
목적 관찰단독광동력요법(PDT)급단차PDT연합파리체강주사Avastin치료병이성근시(PM)맥락막신생혈관(CNV)적료효.방법 회고성계렬병례연구.경형광소안저혈관조영(FFA)/신타청록혈관조영(ICGA)급광학상간단층소묘(OCT)학진위PM계발황반구CNV,차CNV처우활동기환자38례(38안)납입본연구.비수궤분조행단독PDT급단차PDT연합파리체강주사Avastin치료,기중단독PDT치료조21례(21안),단차PDT연합파리체강주사Avastin치료조17례(17안).치료전이용당뇨병시망막병변조기치료연구(ETDRS)시력표검사환자가독취적자모수,미시야계(MP-1)검사황반구중심20°평균광민감도(MS),OCT측량황반중심요시망막신경상피층후도.치료후1、3、6개월수방,검사안저병대비량조치료전후급량조지간가독취자모수、황반중심요신경상피층후도급MS치.약CNV재차삼루,칙수중복치료.채용독립양본t검험급배대t검험진행분석.결과 치료후6개월,단독PDT치료조급단차PDT연합파리체강주사Avastin치료조가독취자모수、황반중심요시망막후도급MS교치료전유현저개선,차이유통계학의의(단독PDT치료조:=-4.45、10.72、-8.62,P＜0.01;단차PDT연합파리체강주사Avastin치료조:t=-9.28、8.72、-11.54,P＜0.01).치료후1、3、6개월,량치료조간가독취자모수급황반중심요시망막후도비교차이무통계학의의(P＞0.05);단차PDT연합파리체강주사Avastin치료조MS치고우단독PDT치료조,차이유통계학의의(t=-2.86、-2.15、-2.50,P＜0.05).결론 단차PDT연합파리체강주사Avastin치료교단독PDT치료능은정、개선PM성CNV환자시망막민감도,단수수궤、대양본연구증실.
Objective To observe the changes in visual function after photodynamic therapy (PDT) and PDT combined with an intravitreal injection of Avastin for macular choroidal neovascularization (CNV) secondary to pathological myopia (PM).Methods Thirty-eight patients (38 eyes) with active CNV secondary to PM were included in a retrospective case series study.Twentyone patients (21 eyes) were treated with PDT (PDT group),while 17 patients (17 eyes) were treated with PDT combined with an intravitreal injection of Avastin (1.25 mg) (combination group).All patients were assessed by an early treatment of diabetic retinopathy study (ETDRS) chart,optical coherence tomography (OCT) and MP-1 microperimetry before and 1,3,and 6 months after treatment.Results were recorded and compared for the number of recognized letters,foveal nerve fiber layer thickness and macular median sensitivity (MS) within a central 20° area.Treatments were repeated if CNV leaked again.Data were analyzed using independent samples t test and paired t test.Results Six months after treatments,the numbers of recognized letters had increased,foveal retinal thickness had decreased and MS had increased in both the PDT group and combination group,and the differences were statistically significant (PDT group:t=-4.45,10.72,-8.62,P＜0.01; combination group:t=-9.28,8.72,-11.54,P＜0.01).In the following month (7 months after treatment),the differences in the number of recognized letters and foveal nerve fiber layer thickness were not statistically significant between the PDT group and combination group (P＞0.05),while the differences in MS were statistically significant (t=-2.86,-2.15,-2.50,P＜0.05).Conclusion PDT combined with an intravitreal injection of Avastin could effectively stabilize and improve the macular median sensitivity for CNV secondary to PM.