Matsuhashi H, Noda Y, Takahashi D, Mariya Y
Department of Ophthalmology, Hirosaki University School of Medicine, Hirosaki, Japan.
Jpn J Ophthalmol. 2000 Nov-Dec;44(6):653-60. doi: 10.1016/s0021-5155(00)00280-x.
To evaluate the effects of radiation therapy on age-related macular degeneration with subfoveal or juxtafoveal choroidal neovascularization < or =1 disc area.
Fourteen patients (14 eyes) received a total radiation dose of 10-20 Gy in 5-10 fractions. The mean follow-up time was 22 months. Ten patients (10 eyes) in a control group were followed up for an average of 16 months without treatment.
At a 12-month posttreatment examination, funduscopic and angiographic findings showed improvement in 7 eyes (50%), no change in 1 eye (7%), and deterioration in 6 eyes (43%) among the treated patients. The same findings demonstrated improvement in 1 eye (10%), no change in 2 eyes (20%), and deterioration in 7 eyes (70%) among the control patients. This difference was determined to be statistically significant between the two groups by the Mann-Whitney U-test. Visual acuity had improved in 4 eyes (29%), was unchanged in 6 eyes (43%), and had declined in 4 eyes (29%), among the treated patients. Among the control patients, visual acuity had improved in none of the eyes (0%), was unchanged in 6 eyes (60%), and had declined in 4 eyes (40%). The difference in visual acuity between the two groups was not statistically significant.
Radiation therapy inhibited small choroidal neovascularization, as seen by funduscopy and angiography, but its effectiveness in improving visual prognosis was not always evident.
评估放射治疗对黄斑中心凹或黄斑中心凹旁脉络膜新生血管面积≤1个视盘面积的年龄相关性黄斑变性的疗效。
14例患者(14只眼)接受了总量为10 - 20 Gy、分5 - 10次的放射治疗。平均随访时间为22个月。对照组10例患者(10只眼)未接受治疗,平均随访16个月。
在治疗后12个月的检查中,眼底镜和血管造影检查结果显示,治疗组患者中7只眼(50%)病情改善,1只眼(7%)无变化,6只眼(43%)病情恶化。对照组患者中1只眼(10%)病情改善,2只眼(20%)无变化,7只眼(70%)病情恶化。经曼-惠特尼U检验确定两组之间的这种差异具有统计学意义。治疗组患者中4只眼(29%)视力提高,6只眼(43%)视力无变化,4只眼(29%)视力下降。对照组患者中无眼视力提高(0%),6只眼(60%)视力无变化,4只眼(40%)视力下降。两组之间的视力差异无统计学意义。
放射治疗可抑制小脉络膜新生血管,这在眼底镜检查和血管造影中可见,但在改善视力预后方面的有效性并不总是明显的。