Busquets M A, Shah G K, Wickens J, Callanan D, Blinder K J, Burgess D, Grand M G, Holekamp N M, Boniuk I, Joseph D P, Thomas M A, Fish E, Bakal J, Hollands H, Sharma S
Barnes Retina Institute and Washington University School of Medicine, St. Louis, Missouri 63144, USA.
Retina. 2003 Jun;23(3):299-306. doi: 10.1097/00006982-200306000-00003.
To evaluate the use of ocular photodynamic therapy (OPT) with verteporfin in patients with choroidal neovascularization (CNV) from ocular histoplasmosis syndrome (OHS) and to compare these results with those for a natural history group.
A retrospective chart review was performed to identify cases of CNV secondary to OHS treated with OPT. Complete data were available for 38 of 41 eligible eyes. Data regarding the following variables were abstracted from the patient charts: demographic characteristics, previous surgery, angiographic features, number and timing of treatments with OPT, follow-up time, and visual acuity. The visual acuity results of eyes receiving photodynamic therapy were compared with those for a natural history cohort.
On average, OHS patients who received treatment developed 0.88 line of visual improvement. Visual acuity improved or stayed the same in 69% (22 of 32) of eyes, improved by > or = 2 lines in 44% (14 of 32), and improved by > or = 4 lines in 22% (7 of 32). Patients who received OPT were 2.07 times more likely to have improved or constant vision than were those in the natural history group as described in one retrospective series (odds ratio = 2.07; 95% confidence interval, 0.78-5.56; P = 0.162). Thirty-eight percent (12 of 32) of eyes had undergone submacular surgery for CNV before any OPT.
Ocular photodynamic therapy with verteporfin may be beneficial in patients with CNV secondary to OHS, even in the setting of previous submacular surgery.
评估维替泊芬眼内光动力疗法（OPT）用于治疗眼部组织胞浆菌病综合征（OHS）所致脉络膜新生血管（CNV）患者的疗效，并将这些结果与自然病程组进行比较。
进行一项回顾性病历审查，以确定接受OPT治疗的OHS继发CNV病例。41只符合条件的眼中有38只获得了完整数据。从患者病历中提取了以下变量的数据：人口统计学特征、既往手术史、血管造影特征、OPT治疗的次数和时间、随访时间及视力。将接受光动力治疗的眼睛的视力结果与自然病程队列的结果进行比较。
接受治疗的OHS患者平均视力提高了0.88行。69%（32只眼中的22只）的眼睛视力提高或保持不变，44%（32只眼中的14只）的眼睛视力提高≥2行，22%（32只眼中的7只）的眼睛视力提高≥4行。如一项回顾性系列研究所述，接受OPT治疗的患者视力改善或保持稳定的可能性是自然病程组患者的2.07倍（优势比 = 2.07；95%置信区间，0.78 - 5.56；P = 0.162）。38%（32只眼中的12只）的眼睛在接受任何OPT治疗之前已因CNV接受了黄斑下手术。
维替泊芬眼内光动力疗法可能对OHS继发CNV患者有益，即使是在既往有黄斑下手术的情况下。
