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维替泊芬光动力疗法治疗中国患者病理性近视性黄斑下脉络膜新生血管:一项为期1年和2年随访的前瞻性研究。

Photodynamic therapy with verteporfin for subfoveal choroidal neovascularisation of pathologic myopia in Chinese eyes: a prospective series of 1 and 2 year follow up.

作者信息

Lam D S C, Chan W-M, Liu D T L, Fan D S P, Lai W W, Chong K K L

机构信息

Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, University Eye Center, Hong Kong Eye Hospital, 147K, Argyle Street, Kowloon, Hong Kong. People's Republic of China.

出版信息

Br J Ophthalmol. 2004 Oct;88(10):1315-9. doi: 10.1136/bjo.2004.041624.

Abstract

AIMS

To evaluate the visual and fluorescein angiographic outcomes of photodynamic therapy (PDT) with verteporfin in patients with subfoveal choroidal neovascularisation (CNV) caused by pathologic myopia in the Chinese.

METHODS

Prospective, non-comparative, two centre interventional study. Patients with CNV secondary to pathologic myopia of Chinese ethnicity were recruited and treated with a standard regimen of PDT with verteporfin. Results of this study in Chinese eyes with pigmented retinal pigment epithelium were compared with those from the Verteporfin in Photodynamic Therapy (VIP) Study of predominantly white eyes.

RESULTS

Thirty one and 22 eyes that completed the 12 month and 24 month follow up studies respectively were analysed. The mean and median best corrected visual acuities (BCVA) could be maintained at the baseline level at the 12 month and 24 month visits. Fourteen (63.6%) eyes had stable or improved BCVA at 24 months and six (27.3%) of them had a moderate gain in vision (improved by three or more lines). Visual results were comparable with that of the VIP study, but the average accumulative PDT treatments required in one and two years were 1.7 and 2.3 respectively, which were significantly less than 3.4 and 5.1 treatments in VIP study. Mean logMAR BCVA of the younger age group (<55 years) at 24 months was 0.41 (SD 0.29), which was significantly better than the older age group (>/= = 55 years) of 0.82 (SD 0.40) (Mann-Whitney U test, p = 0.029).

CONCLUSIONS

PDT using the predetermined treatment protocol has achieved similar visual outcomes in the Chinese population as in white people with subfoveal myopic CNV over a 2 year study period. The complete cessation of CNV leakage can be accomplished, on average, with fewer PDT retreatments than reported in the VIP study. The disparity may be due to ethnic differences in these two populations.

摘要

目的

评估在中国病理性近视引起的黄斑下脉络膜新生血管(CNV)患者中,使用维替泊芬进行光动力疗法(PDT)后的视力及荧光素血管造影结果。

方法

前瞻性、非对照、双中心干预性研究。招募患有病理性近视继发CNV的中国患者,并用维替泊芬标准方案进行治疗。将本研究中中国有色素视网膜色素上皮的眼睛的结果与主要为白人眼睛的光动力疗法(VIP)研究结果进行比较。

结果

分别对31只和22只完成了12个月和24个月随访研究的眼睛进行分析。在12个月和24个月随访时,平均及中位数最佳矫正视力(BCVA)可维持在基线水平。14只(63.6%)眼睛在24个月时BCVA稳定或提高,其中6只(27.3%)视力有中度提高(提高3行或更多行)。视力结果与VIP研究相当,但1年和2年所需的平均累积PDT治疗次数分别为1.7次和2.3次,显著少于VIP研究中的3.4次和5.1次。24个月时较年轻年龄组(<55岁)的平均logMAR BCVA为0.41(标准差0.29),显著优于较年长年龄组(≥55岁)的0.82(标准差0.40)(曼-惠特尼U检验,p = 0.029)。

结论

在为期2年的研究期间,使用预定治疗方案的PDT在中国人群中与患有黄斑下近视性CNV的白人取得了相似的视力结果。平均而言,与VIP研究相比,完成CNV渗漏完全停止所需的PDT再次治疗次数更少。这种差异可能是由于这两个人群的种族差异。

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