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2A型特发性黄斑旁视网膜毛细血管扩张症中心凹下新生血管膜的光动力疗法

Photodynamic therapy of subfoveal neovascular membrane in type 2A idiopathic juxtafoveolar retinal telangiectasis.

作者信息

Snyers Bernadette, Verougstraete Claire, Postelmans Laurence, Leys Anita, Hykin Philip

机构信息

Cliniques Universitaires St. Luc, Université Catholique de Louvain, Avenue Hippocrate 10, B-1200 Brussels, Belgium.

出版信息

Am J Ophthalmol. 2004 May;137(5):812-9. doi: 10.1016/j.ajo.2003.11.076.

Abstract

PURPOSE

To evaluate the effect of photodynamic therapy on subfoveal neovascular membrane related to type 2A idiopathic juxtafoveolar retinal telangiectasia.

DESIGN

Interventional case series.

METHODS

Retrospective review of four eyes of four patients who underwent photodynamic therapy for subfoveal neovascular membrane secondary to idiopathic juxtafoveolar retinal telangiectasia. Ocular photodynamic therapy with verteporfin was performed in all cases using standard protocols. Results are given in terms of final visual acuity and neovascular membrane activity based on clinical examination, fluorescein and indocyanin green angiography, and, in two cases, optical coherence tomography.

RESULTS

Baseline visual acuity of 20/30 and 20/40 (x2) was maintained in three patients after one, two, and three sessions of photodynamic therapy respectively, and a follow-up of 23, 21, and 9 months. Leakage specific to the subfoveal neovascular membrane ceased on the fluorescein angiography. In the other patient, the final vision decreased from 20/50 to 20/200 after four sessions of photodynamic therapy and a follow-up of 14 months. Although there was still mild persistent leakage on the fluorescein angiography, neovascular membrane size was unchanged, and no subretinal fluid was demonstrated on optical coherence tomography.

CONCLUSIONS

Data from this case series suggest that photodynamic therapy may be effective in managing subfoveal neovascular membrane associated with idiopathic juxtafoveolar retinal telangiectasia, which usually carries a poor visual prognosis. Prospective study is required to confirm the beneficial effect of this treatment.

摘要

目的

评估光动力疗法对与2A型特发性黄斑旁视网膜毛细血管扩张症相关的黄斑下新生血管膜的疗效。

设计

介入性病例系列。

方法

回顾性分析4例因特发性黄斑旁视网膜毛细血管扩张症继发黄斑下新生血管膜而接受光动力疗法的患者的4只眼。所有病例均采用标准方案进行维替泊芬眼部光动力治疗。根据最终视力和基于临床检查、荧光素和吲哚菁绿血管造影以及2例患者的光学相干断层扫描的新生血管膜活性给出结果。

结果

3例患者分别在接受1次、2次和3次光动力治疗后,随访23个月、21个月和9个月,基线视力20/30和20/40(2例)得以维持。黄斑下新生血管膜的荧光素血管造影渗漏停止。另1例患者在接受4次光动力治疗并随访14个月后,最终视力从20/50降至20/200。尽管荧光素血管造影仍有轻度持续性渗漏,但新生血管膜大小未变,光学相干断层扫描未显示视网膜下液。

结论

该病例系列的数据表明,光动力疗法可能对治疗与特发性黄斑旁视网膜毛细血管扩张症相关的黄斑下新生血管膜有效,该病通常视力预后较差。需要进行前瞻性研究以证实该治疗的有益效果。

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