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[II型膜增生性肾小球肾炎中的脉络膜新生血管形成,光动力疗法作为一种治疗选择——病例报告]

[Choroidal neovascularisation in type II membranoproliferative glomerulonephritis, photodynamic therapy as a treatment option--a case report].

作者信息

Hassenstein Andrea, Richard Gisbert

机构信息

Universitäts-Augenklinik Hamburg-Eppendorf.

出版信息

Klin Monbl Augenheilkd. 2003 Jul;220(7):492-5. doi: 10.1055/s-2003-40937.

Abstract

BACKGROUND

Photodynamic therapy (PDT) is an established treatment in predominantly classic choroidal neovascularisation (CNV) in exudative age-related macular degeneration (AMD). Membranoproliferative glomerulonephritis (MPGN) type II leads to AMD-similar changes ("pseudo-AMD") of the fundus with CNV as a late complication. We report on a patient suffering from MPGN II and a classic CNV who was treated with PDT.

PATIENT AND METHOD

A 31-year old male patient suffering from MPGN II from the age of 8 presented with visual deterioration and metamorphopsies on his left eye (VA OD 1.0, OS 0.25). Funduscopy revealed a "Pseudo"-AMD on both eyes and the left eye showed a 100 % classic CNV in fluorescein angiography (FLA). The left eye has treated with PDT. Visual acuity after PDT remained stable with 0.25 OS and metamorphopsies were reduced. 3 months later FLA showed a small residual leakage, therefore a second PDT was performed. 4 months after the 2 nd PDT the patient suffered again from metamorphopsies with a stable VA of 0.25 OS following a 3 rd PDT.

RESULTS

Visual acuity of the left eye remained stable at 0.25 and metamorphopsies reduced due to the treatment of 3 PDT's. Even in "pseudo-AMD" in MPGN II the PDT is able to reduce leakage and stops progression consistent to the results in exudative AMD.

CONCLUSION

In MPGN II associated "pseudo"-AMD with classic CNV the PDT was also successful. The origin of the CNV does not appear to play a role for the success of the PDT.

摘要

背景

光动力疗法(PDT)是治疗渗出性年龄相关性黄斑变性(AMD)中主要为典型脉络膜新生血管(CNV)的一种既定疗法。II型膜增生性肾小球肾炎(MPGN)会导致眼底出现与AMD相似的变化(“假性AMD”),CNV是其晚期并发症。我们报告了一名患有II型MPGN和典型CNV的患者接受了PDT治疗。

患者与方法

一名31岁男性患者,8岁起患有II型MPGN,左眼出现视力下降和视物变形(右眼视力1.0,左眼0.25)。眼底检查显示双眼均有“假性”AMD,左眼在荧光素血管造影(FLA)中显示100%为典型CNV。左眼接受了PDT治疗。PDT治疗后视力保持稳定,左眼为0.25,视物变形减轻。3个月后FLA显示有少量残余渗漏,因此进行了第二次PDT治疗。第二次PDT治疗4个月后,患者再次出现视物变形,第三次PDT治疗后左眼视力稳定在0.25。

结果

由于进行了3次PDT治疗,左眼视力保持稳定在0.25,视物变形减轻。即使在II型MPGN的“假性AMD”中,PDT也能够减少渗漏并阻止病情进展,这与渗出性AMD的结果一致。

结论

在与II型MPGN相关的伴有典型CNV的“假性”AMD中,PDT治疗也取得了成功。CNV的起源似乎对PDT治疗的成功没有影响。

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