Blasi Maria A, Scupola Andrea, Tiberti Alessandra C, Sasso Paola, Balestrazzi Emilio
Department of Ophthalmology, University of L'Aquila, San Salvatore Hospital, Via Vetoio, 67100 Coppito, L'Aquila, Italy.
Retina. 2006 Apr;26(4):404-9. doi: 10.1097/01.iae.0000238554.61165.fd.
To report our experience with photodynamic therapy (PDT) with verteporfin for patients with vasoproliferative retinal tumors (VPRTs).
Three patients with VPRTs who presented with macular exudative changes were treated with one session of PDT with 6 mg/m body surface area of verteporfin and a light dose of 100 J/cm at 689 nm delivered in 166 seconds. Biomicroscopy, fluorescein angiography, indocyanine green angiography, optical coherence tomography, and ultrasonography were performed before treatment and 1 month, 3 months, 6 months, and 1 year after treatment; visual acuity was measured using Early Treatment Diabetic Retinopathy Study criteria.
At the 1-year follow-up, all tumors responded with a reduction in size (mean height: pretreatment, 2.96 mm; posttreatment, 1.32 mm), and optical coherence tomography showed complete resolution of macular exudates. For all patients, fluorescein angiography evidenced reduction of leakage from the lesion, and indocyanine green angiography verified nonperfusion of the vascular channels. An improvement in visual acuity (average, 4.7 Early Treatment Diabetic Retinopathy Study letters) was observed. No retreatment was needed.
PDT may represent an effective and safe modality of treatment for VPRTs because of its selectivity. Our study supports the application of a light dose of 100 J/cm, although further studies with larger numbers of cases and longer follow-ups are required.
报告我们使用维替泊芬光动力疗法(PDT)治疗视网膜血管增生性肿瘤(VPRT)患者的经验。
3例出现黄斑渗出性改变的VPRT患者接受了一次PDT治疗,维替泊芬剂量为6mg/m²体表面积,在689nm波长下以166秒给予100J/cm²的光剂量。在治疗前以及治疗后1个月、3个月、6个月和1年进行生物显微镜检查、荧光素血管造影、吲哚菁绿血管造影、光学相干断层扫描和超声检查;使用早期糖尿病视网膜病变研究标准测量视力。
在1年随访时,所有肿瘤均有反应,大小缩小(平均高度:治疗前2.96mm;治疗后1.32mm),光学相干断层扫描显示黄斑渗出完全消退。所有患者的荧光素血管造影显示病变渗漏减少,吲哚菁绿血管造影证实血管通道无灌注。观察到视力有所改善(平均提高4.7个早期糖尿病视网膜病变研究字母)。无需再次治疗。
由于其选择性,PDT可能是一种治疗VPRT的有效且安全的方法。我们的研究支持使用100J/cm²的光剂量,尽管需要更多病例和更长随访时间的进一步研究。