CAJ | 학술논문

目的研究光动力疗法(PDT)治疗高原地区新生血管性年龄相关性黄斑变性(AMD)的临床疗效.方法开放性非对照研究.对2010年12月至2013年5月在青海省人民医院采用PDT治疗新生血管性AMD的患者44例47只眼,随访半年的临床疗效.其中,经典为主型(典型CNV≥整个病灶的50％)31只眼(31/47占65.96％),微小经典型(典型CNV＜整个病灶的50％)16只眼(16/47占34.04％).治疗前视力0.02～0.6,病灶平均最大线性距离(GLD)为950.0～2712.3 μm.结果 47只眼随访半年,术后视力稳定41只眼(41/47占87.23％),下降6只眼(6/47占12.77％);术后眼底荧光血管造影(FFA)和吲哚菁绿血管造影(ICGA)渗漏无增加44只眼(44/47占93.62％),渗漏增加3只眼(3/47占6.38％).治疗后中心视网膜厚度(CRT)明显降低,差异具有统计学意义(t=11.07,P＜0.01).有2例术后发生腰背部酸痛反应,不良反应发生率为4.26％ (2/47).结论 PDT可以有效治疗高原地区新生血管性AMD,减轻新生血管的渗漏,保持AMD患者视力稳定,无明显不良反应发生,治疗安全;但治疗后仍有复发需再次治疗.
목적 연구광동력요법(PDT)치료고원지구신생혈관성년령상관성황반변성(AMD)적림상료효.방법 개방성비대조연구.대2010년12월지2013년5월재청해성인민의원채용PDT치료신생혈관성AMD적환자44례47지안,수방반년적림상료효.기중,경전위주형(전형CNV≥정개병조적50％)31지안(31/47점65.96％),미소경전형(전형CNV＜정개병조적50％)16지안(16/47점34.04％).치료전시력0.02～0.6,병조평균최대선성거리(GLD)위950.0～2712.3 μm.결과 47지안수방반년,술후시력은정41지안(41/47점87.23％),하강6지안(6/47점12.77％);술후안저형광혈관조영(FFA)화신타정록혈관조영(ICGA)삼루무증가44지안(44/47점93.62％),삼루증가3지안(3/47점6.38％).치료후중심시망막후도(CRT)명현강저,차이구유통계학의의(t=11.07,P＜0.01).유2례술후발생요배부산통반응,불량반응발생솔위4.26％ (2/47).결론 PDT가이유효치료고원지구신생혈관성AMD,감경신생혈관적삼루,보지AMD환자시력은정,무명현불량반응발생,치료안전;단치료후잉유복발수재차치료.
Objective To study the clinical efficacy about photodynamic therapy (PDT) in the treatment of neovascular age-related macular degeneration (AMD) in the plateau region.Methods The open controlled study.The clinical efficacy about 44 cases AMD of 47 eyes treated with PDT in Qinghai province people's hospital from December 2010 to May 2013,followed up for half a year.Among them,typicality mainly CNV were 31 eyes (31/47,65.96％),mildly abnormal CNV 16 eyes (16/47,34.04％).The former vision was 0.02 to 0.6,lesions average maximum linear distance (GLD) of (950.0～2712.3)μm.Results Forty-seven eyes were followed up for half a year,visual acuity of 41 eyes (41/47,87.23％) was stable postoperatively,6 eyes (6/47,12.77％) felled;no fundus fluorescence angiography (FFA) and indocyanine green angiography (ICGA) leakage increased in 44 eyes that accounted for 93.62％ (44/47) postoperatively,while 3 eyes had leakage increased that accounted for 6.38％ (3/47).Central retinal thickness (CRT) decreased after treatment significantly,the difference was statistically significant (t =11.07,P ＜0.01);2 cases had postoperative lumbar back pain reaction,and the incidence of adverse reactions was 4.26％ (2/47).Conclusions It is effective by PDT treatment neovascular AMD in plateau area,creduce the leakage of new blood vessels,keeping AMD vision in patients with stable,no obvious adverse reaction occurred,is security.However,there is still a relapse after treatment which needs treatment again.