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年龄相关性黄斑变性:黄斑中心凹下新生血管膜放射治疗的长期结果

Age-related macular degeneration: long-term results of radiotherapy for subfoveal neovascular membranes.

作者信息

Kobayashi H, Kobayashi K

机构信息

Department of Ophthalmology, Amagasaki Hospital, (Dr H. Kobayashi), Hyogo, Japan.

出版信息

Am J Ophthalmol. 2000 Nov;130(5):617-35. doi: 10.1016/s0002-9394(00)00534-1.

DOI:10.1016/s0002-9394(00)00534-1
PMID:11078841
Abstract

PURPOSE

To study results of 2-year follow-up of radiotherapy for subfoveal choroidal neovascular membrane associated with age-related macular degeneration.

METHODS

In a randomized prospective clinical study, 101 patients received a low-dose radiotherapy or no treatment. In the treatment group, subfoveal choroidal neovascular membranes were treated with 20 Gy of 6-MV photons to the macula of the affected eye.

RESULTS

The overall complete follow-up rate was 84.2% (85/101). No measurable treatment-related morbidity was seen during or after treatment. Mean changes in log of minimal angle of resolution (logMAR) of visual acuity and area of choroidal neovascular membrane for 2-year follow-up were +0.226 +/- 0.373 and 143.5 +/- 53.1% in the treatment group, and +0.563 +/- 0.370 and 190. 3 +/- 81.4% in the control group; a significant difference was found (P <.0001; P =.0008). In patients with smaller choroidal neovascular membrane (</=1.5 mm(2)) or better visual acuity (>/=60/200) at baseline, the treatment group showed a significantly smaller increase in area of choroidal neovascular membrane and a significantly smaller decrease in LogMAR visual acuity for 2 years, whereas there was no significant difference in patients with larger choroidal neovascular membrane (>1.5 mm(2)) or poorer visual acuity (<60/200).

CONCLUSIONS

Radiotherapy appeared to have a favorable treatment effect in eyes with subfoveal neovascular membrane associated with AMD. Favorable factors for radiotherapy were a smaller area of choroidal neovascular membrane and better visual acuity.

摘要

目的

研究年龄相关性黄斑变性伴中心凹下脉络膜新生血管膜放射治疗的2年随访结果。

方法

在一项随机前瞻性临床研究中,101例患者接受了低剂量放射治疗或未接受治疗。治疗组中,对患眼黄斑区用6兆伏光子给予20戈瑞的照射,以治疗中心凹下脉络膜新生血管膜。

结果

总体完全随访率为84.2%(85/101)。治疗期间及治疗后均未见可测量的与治疗相关的发病率。治疗组2年随访时视力最小分辨角对数(logMAR)和脉络膜新生血管膜面积的平均变化分别为+0.226±0.373和143.5±53.1%,对照组分别为+0.563±0.370和190.3±81.4%;差异有统计学意义(P<.0001;P=.0008)。基线时脉络膜新生血管膜较小(≤1.5平方毫米)或视力较好(≥60/200)的患者,治疗组2年时脉络膜新生血管膜面积增加明显较小,logMAR视力下降也明显较小,而脉络膜新生血管膜较大(>1.5平方毫米)或视力较差(<60/200)的患者则无明显差异。

结论

放射治疗对年龄相关性黄斑变性伴中心凹下新生血管膜的眼睛似乎有良好的治疗效果。放射治疗的有利因素是脉络膜新生血管膜面积较小和视力较好。

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