Blair Michael P, Apte Rajendra S, Miskala Päivi H, Bressler Susan B, Goldberg Morton F, Schachat Andrew P, Bressler Neil M
Retinal Vascular Center, Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Retina. 2004 Aug;24(4):501-6. doi: 10.1097/00006982-200408000-00001.
To describe visual acuity and angiographic outcomes of juxtafoveal choroidal neovascularization (CNV) treated with photodynamic therapy and verteporfin (PDT).
Four hundred eighty-four consecutive eyes of 446 patients treated with PDT from January 1, 2001, to June 30, 2002, were identified from billing records. Fluorescein angiograms were reviewed retrospectively to identify juxtafoveal CNV. Eligible patients had CNV in which the central boundary of the lesion was between 1 and 199 microm from the geometric center of the foveal avascular zone (FAZ). Patient charts were reviewed for visual acuity of the treated eye before PDT and at 6- and 12-month follow-up examinations. Presence of subfoveal CNV at 6 and 12 months of follow-up was determined by review of fluorescein angiograms. A lesion was considered subfoveal if it extended underneath the geometric center of the FAZ.
Twenty-one eyes had juxtafoveal CNV. Median change in visual acuity both 6 and 12 months after the initial PDT was 0 lines (n = 18 at 6 months, range -14 to + 8 lines; n = 17 at 12 months, range -18 to + 7 lines). Eleven lesions progressed to a subfoveal location by 12 months. Visual acuity in eyes with progressive lesions decreased a median of 4 lines of vision.
Despite a small sample size and limited length of follow-up, this study shows that visual acuity on average can remain stable for at least 12 months after PDT of juxtafoveal lesions. Growth through the foveal center still can occur, however, and this can be associated with substantial visual loss.
描述采用光动力疗法及维替泊芬（PDT）治疗的近黄斑中心凹脉络膜新生血管（CNV）的视力及血管造影结果。
从2001年1月1日至2002年6月30日接受PDT治疗的446例患者的484只连续眼中，通过计费记录进行识别。对荧光素血管造影进行回顾性分析以识别近黄斑中心凹CNV。符合条件的患者的CNV病变中心边界距黄斑无血管区（FAZ）几何中心1至199微米。查阅患者病历，了解治疗眼在PDT前以及6个月和12个月随访检查时的视力情况。通过回顾荧光素血管造影确定随访6个月和12个月时黄斑中心凹下CNV的存在情况。如果病变延伸至FAZ几何中心下方，则认为该病变位于黄斑中心凹下。
21只眼患有近黄斑中心凹CNV。初次PDT后6个月和12个月时视力的中位数变化均为0行（6个月时n = 18，范围为-14至+8行；12个月时n = 17，范围为-18至+7行）。到12个月时，11个病变进展至黄斑中心凹下位置。病变进展的眼中视力中位数下降4行。
尽管样本量小且随访时间有限，但本研究表明，近黄斑中心凹病变接受PDT治疗后，平均视力至少可在12个月内保持稳定。然而，仍可能发生病变穿过黄斑中心凹，这可能导致明显的视力丧失。
