PDT联合玻璃体腔注射Bevacizumab治疗慢性中心性浆液性视网膜脉络膜病变观察
PDT연합파리체강주사Bevacizumab치료만성중심성장액성시망막맥락막병변관찰
Low-fluence photodynamic combination intravitreal bevacizumab for treatment of chronic central serous choroiretinopathy
  • 万方数据
    中国实用眼科杂志 중국실용안과잡지
    Chinese Journal of Practical Ophthalmology
    2015年 8期 894-898 ,共5页

    陈青山%孙良南%李志%姚丽莉%曾键

    진청산%손량남%리지%요려리%증건

    中心性浆液性视网膜脉络膜病变%光动力疗法%贝伐单抗%浆液性色素上皮脱离 中心性漿液性視網膜脈絡膜病變%光動力療法%貝伐單抗%漿液性色素上皮脫離
    중심성장액성시망막맥락막병변%광동력요법%패벌단항%장액성색소상피탈리
    CSC%PDT%Bevacizumab%Serous PED
    目的 观察低剂量光动力疗法(PDT)联合抗血管内皮生长因子单克隆抗体贝伐单抗(Bevacizumab)玻璃体腔注射治疗伴有浆液性色素上皮脱离(PED)的慢性中心性浆液性视网膜脉络膜病变(CSC)的疗效.方法 临床病例对照研究.回顾分析对2010年6月至2013年6月在深圳市眼科医院FFA与OCT确诊伴有浆液性PED的慢性CSC患者29例(35只眼).男24例,女5例,双眼患者6例,平均年龄(41±7.5)岁.患者分为单一低剂量(25J/cm2) PDT治疗组16例(19只眼);低剂量PDT联合玻璃体腔注射Bevacizumab治疗组13例(16只眼),以下简称联合治疗组.治疗后1、3、6个月观察最小分辨角矫正视力(LogMAR BCVA),PED平伏率,黄斑中心视网膜厚度(CFT)改变.结果治疗后1个月随诊联合治疗组BCVA (0.33±0.48),单-PDT治疗组BCVA (0.46±0.52) logMAR,两组与基线视力比较及两组间比较差异无统计学意义(t =0.63,P=0.48).治疗后3,6个月随访联合治疗组BCVA分别为(0.24±0.46) logMAR;(0.19±0.48) logMAR,单-PDT治疗组BCVA (0.35±0.70)logMAR;(0.31±0.50) logMAR,两组与基线视力比较差异有统计学意义(P =0.03;P=0.01).治疗后6个月随访,单一PDT治疗组与联合组治疗后CFT比较基线CFT显著降低差异有统计学意义(t=2.66;5.88,P=0.02;0.00).治疗后6月随访联合治疗组CFT较PDT单一治疗组CFT显著降低,差异有统计学意义(t =2.81,P=0.005).治疗6个月联合治疗组黄斑视网膜神经上皮下浆液吸收与PED平伏均为13只眼(81.25％),单一PDT治疗组黄斑视网膜神经上皮下浆液吸收12只眼(63.15％),PED平伏8只眼(42.10％),两组相比较差异有统计学意义(x2=2.78,P＜0.05).联合治疗组平均玻璃体注射次数1.38次,单一PDT治疗组平均治疗1.06次.结论 低剂量PDT联合玻璃体注射抗新生血管生长因子与单一低剂量PDT均能提高伴有PED的慢性CSC最佳矫正视力.联合治疗组降低黄斑中心视网膜厚度,平伏PED效果优于单一PDT组.提示低剂量PDT联合璃体腔注射抗新生血管因子治疗对伴有PED的慢性CSC疗效较好.
    목적 관찰저제량광동력요법(PDT)연합항혈관내피생장인자단극륭항체패벌단항(Bevacizumab)파리체강주사치료반유장액성색소상피탈리(PED)적만성중심성장액성시망막맥락막병변(CSC)적료효.방법 림상병례대조연구.회고분석대2010년6월지2013년6월재심수시안과의원FFA여OCT학진반유장액성PED적만성CSC환자29례(35지안).남24례,녀5례,쌍안환자6례,평균년령(41±7.5)세.환자분위단일저제량(25J/cm2) PDT치료조16례(19지안);저제량PDT연합파리체강주사Bevacizumab치료조13례(16지안),이하간칭연합치료조.치료후1、3、6개월관찰최소분변각교정시력(LogMAR BCVA),PED평복솔,황반중심시망막후도(CFT)개변.결과치료후1개월수진연합치료조BCVA (0.33±0.48),단-PDT치료조BCVA (0.46±0.52) logMAR,량조여기선시력비교급량조간비교차이무통계학의의(t =0.63,P=0.48).치료후3,6개월수방연합치료조BCVA분별위(0.24±0.46) logMAR;(0.19±0.48) logMAR,단-PDT치료조BCVA (0.35±0.70)logMAR;(0.31±0.50) logMAR,량조여기선시력비교차이유통계학의의(P =0.03;P=0.01).치료후6개월수방,단일PDT치료조여연합조치료후CFT비교기선CFT현저강저차이유통계학의의(t=2.66;5.88,P=0.02;0.00).치료후6월수방연합치료조CFT교PDT단일치료조CFT현저강저,차이유통계학의의(t =2.81,P=0.005).치료6개월연합치료조황반시망막신경상피하장액흡수여PED평복균위13지안(81.25％),단일PDT치료조황반시망막신경상피하장액흡수12지안(63.15％),PED평복8지안(42.10％),량조상비교차이유통계학의의(x2=2.78,P＜0.05).연합치료조평균파리체주사차수1.38차,단일PDT치료조평균치료1.06차.결론 저제량PDT연합파리체주사항신생혈관생장인자여단일저제량PDT균능제고반유PED적만성CSC최가교정시력.연합치료조강저황반중심시망막후도,평복PED효과우우단일PDT조.제시저제량PDT연합리체강주사항신생혈관인자치료대반유PED적만성CSC료효교호.
    Objective To compare low-fluence photodynamic therapy (PDT) combination with intravitreal bevacizumaband mono low-fluence PDT for treatment of chronic central serous choroiretinopathy (CSC) with serous pigmental epithelium detachment (PED).Methods Twenty-nine cases (35 eyes) diagnosed by FFA and ICG were divided into two groups,PDT combination intravitreal bevacizumab (IVB) 13 cases (16 eyes);mono PDT 16 cases (19 eyes).PDT were performed with half dose (25J/cm2) verteporfin and bevacizumab 1.25mg/0.05ml was injected at the pars plana 3.5mm to 4mm.LogMAR BCVA of the cases were examined and central foveal thickness (CFT) was measured by OCT followed up first,third,6th month.FFA was undergone followed up third month.Results Mean BCVA improved significantly without difference between 2 groups at 1 month treatment were than the baseline BCVA (t =0.63,P =0.48).BCVA of combined group post treatment at 3 and 6 months were 0.24,0.46,0.19,0.48;BCVA of mono PDT group 0.35,0.50,0.31,and 0.51.There were significant differences than the baseline BCVA.The CFT of combined group and mono PDT group was decreased than the baseline groups (t =2.87,P =0.01).At 6 months,the CFT of combined group decreased than the mono PDT group (t =2.81,P =0.005).Resolution subretinal fluid 13 eyes (81.25％) and regression of PED 13 eyes (81.25％) in combined group was seen,whereas resolution of subretinal fluid 12 eyes (63.15％) and 8 eyes regression of PED (42.10％) in mono PDT group followed up 6 months (x2=2.78,P ＜0.05).Conclusions No matter how combined group or mono PDT group can improve BCVA,low-fluence PDT combined with IVB decreased CFT and regressed PED could achieve greater efficacy than the mono PDT group.
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