Ruiz-Moreno J M, Montero J A, Barile S
Department of Ophthalmology, Miguel Hernandez University School of Medicine, Alicante and Instituto Oftalmologico de Alicante, Vitreo-Retinal Unit, Alicante--Spain.
Eur J Ophthalmol. 2006 May-Jun;16(3):426-34. doi: 10.1177/112067210601600311.
To evaluate the efficacy of photodynamic therapy (PDT) with verteporfin and intravitreal injection of triamcinolone to treat choroidal neovascularization (CNV) with flat sub-macular hemorrhage in age-related macular degeneration (ARMD).
A prospective, consecutive, noncomparative, interventional case series study was performed at the Instituto Oftalmologico de Alicante, Spain. Ten consecutive eyes from 10 patients with flat submacular hemorrhage secondary to ARMD were treated by PDT followed by intravitreal injection of 19.4+/-2.1 mg/0.1 mL triamcinolone 5 days later. PDT was repeated if leakage from the CNV appeared on fluorescein angiography (FA) at 3 months follow-up intervals. Main outcome measures were best-corrected visual acuity (BCVA) before and after treatment, post-treatment FA, results, and complications.
Stable or improved BCVA was achieved in seven eyes at 6 months follow-up. Complete absence of leakage in FA was observed in five and in eight eyes at 3 and 6 months follow-up, respectively. Intraocular pressure rose in seven eyes.
PDT followed by intravitreal triamcinolone seems useful to treat CNV with flat submacular hemorrhage in ARMD. However, further studies with longer follow-up and randomized controlled trials are necessary to assess its efficacy in the management of this difficult clinical problem.
评估维替泊芬光动力疗法（PDT）联合玻璃体内注射曲安奈德治疗年龄相关性黄斑变性（ARMD）合并黄斑下扁平出血的脉络膜新生血管（CNV）的疗效。
在西班牙阿利坎特眼科研究所进行了一项前瞻性、连续性、非对比性的干预性病例系列研究。对10例因ARMD导致黄斑下扁平出血的患者的10只连续眼睛进行PDT治疗，5天后玻璃体内注射19.4±2.1mg/0.1mL曲安奈德。如果在3个月的随访间隔期荧光素血管造影（FA）显示CNV有渗漏，则重复进行PDT。主要观察指标为治疗前后的最佳矫正视力（BCVA）、治疗后的FA结果及并发症。
6个月随访时，7只眼睛的BCVA稳定或提高。在3个月和6个月随访时，分别有5只和8只眼睛在FA中完全无渗漏。7只眼睛眼压升高。
PDT联合玻璃体内注射曲安奈德似乎对治疗ARMD合并黄斑下扁平出血的CNV有效。然而，需要进一步进行更长时间随访的研究和随机对照试验，以评估其在处理这一棘手临床问题中的疗效。
