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光动力疗法治疗与多灶性脉络膜炎相关的黄斑旁脉络膜新生血管形成

Photodynamic therapy for juxtafoveal choroidal neovascularization associated with multifocal choroiditis.

作者信息

Parodi Maurizio Battaglia, Iacono Pierluigi, Spasse Sonela, Ravalico Giuseppe

机构信息

Eye Clinic, Ospedale Maggiore, Azienda Ospedaliero-Universitaria di Trieste, 34129 Trieste, Italy.

出版信息

Am J Ophthalmol. 2006 Jan;141(1):123-8. doi: 10.1016/j.ajo.2005.07.045.

Abstract

PURPOSE

Evaluation of visual acuity outcome of photodynamic therapy (PDT) with verteporfin for juxtafoveal choroidal neovascularization (CNV) secondary to multifocal choroiditis (MC).

DESIGN

Open-label, prospective, interventional case series.

METHODS

Seven patients (seven eyes) diagnosed with juxtafoveal CNV associated with MC at the Eye Clinic of Trieste were considered. Inclusion criteria were the presence of juxtafoveal CNV no larger than 5400 microm in greatest linear dimension and best-corrected visual acuity (BCVA) (Snellen equivalent) of approximately 20/200 or better. PDT was performed according to the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) study. The primary outcome was the variation in Early Treatment Diabetic Retinopathy Study (ETDRS) charts visual acuity. In particular, the study considered changes of at least eight letters (approximately <1.5 lines of visual acuity loss) at the 12- and 24-month examinations compared with the baseline examination. Secondary outcomes included fluorescein angiographic features such as progression and area of CNV.

RESULTS

At both the 12- and 24-month examinations, three patients (43%) gained at least 1.5 lines of visual acuity, three patients (43%) did not show changes in either direction, whereas visual acuity decreased by 1.5 or more lines from baseline in one patient (14%). The median CNV area was 0.3 mm(2) at baseline and 0.24 mm(2) at the 12- and 24-month controls, respectively.

CONCLUSIONS

The positive results of the present study and the absence of treatment-related side effects suggest that PDT may be considered a safe and viable therapeutic option for juxtafoveal CNV for a 24-month period. Further studies including a greater number of patients are needed to confirm these preliminary results.

摘要

目的

评估维替泊芬光动力疗法(PDT)治疗多灶性脉络膜炎(MC)继发的黄斑旁脉络膜新生血管(CNV)的视力预后。

设计

开放标签、前瞻性、干预性病例系列。

方法

纳入在的里雅斯特眼科诊所诊断为与MC相关的黄斑旁CNV的7例患者(7只眼)。纳入标准为黄斑旁CNV最大线性尺寸不超过5400微米,最佳矫正视力(BCVA)(Snellen等效值)约为20/200或更好。根据年龄相关性黄斑变性光动力疗法(TAP)研究进行PDT治疗。主要结局是早期糖尿病视网膜病变研究(ETDRS)视力表视力的变化。具体而言,该研究考虑与基线检查相比,在12个月和24个月检查时视力至少下降8个字母(约<1.5行视力丧失)的变化。次要结局包括荧光素血管造影特征,如CNV的进展和面积。

结果

在12个月和24个月检查时,3例患者(43%)视力至少提高了1.5行,3例患者(43%)视力在两个方向上均无变化,而1例患者(14%)视力较基线下降了1.5行或更多。CNV面积中位数在基线时为0.3平方毫米,在12个月和24个月对照时分别为0.24平方毫米。

结论

本研究的阳性结果以及无治疗相关副作用表明,PDT在24个月期间可被视为黄斑旁CNV的一种安全可行的治疗选择。需要进一步纳入更多患者的研究来证实这些初步结果。

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