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100例病理性近视患者非黄斑中心凹下脉络膜新生血管的光动力疗法

Photodynamic therapy for nonsubfoveal choroidal neovascularization in 100 eyes with pathologic myopia.

作者信息

Virgili Gianni, Varano Monica, Giacomelli Giovanni, Arena Maria Chiara, Tedeschi Massimiliano, Pascarella Antonella, Catalano Susanna, Menchini Ugo

机构信息

Department of Oto-Neuro-Ophthalmological Surgical Sciences, University of Florence, Viale Morgagni 85, Florence 50134, Italy.

出版信息

Am J Ophthalmol. 2007 Jan;143(1):77-82. doi: 10.1016/j.ajo.2006.09.052. Epub 2006 Oct 25.

Abstract

PURPOSE

To evaluate the visual and anatomic outcome of photodynamic therapy (PDT) in eyes with nonsubfoveal choroidal neovascularization (CNV) associated with pathologic myopia (PM).

DESIGN

Interventional, noncomparative cases series.

METHODS

Ninety-seven patients (100 eyes) who were treated with PDT at three centers and followed up for three to 44 months (mean 16.5 months). Outcome measures were visual acuity, lesion size, and the occurrence of subfoveal invasion.

RESULTS

Median baseline visual acuity was 20/40(-2) and ranged from 20/20 to 20/160(+2). On average, visual acuity was stable throughout follow-up after a modest increase of about 0.5 lines between three and six months. The probability of losing 3 or more lines was 10% to 15% during the second year. Lesion size (median: 710 microns) slightly decreased after the first PDT and tended to increase later, but not to a statistically significant extent compared with baseline. The probability of developing subfoveal CNV stabilized at 10% in the second year. The mean number of PDTs per individual was 2.9 in the first year and 0.6 in the second.

CONCLUSIONS

Visual and anatomic outcomes of PDT, in this large group of patients with nonsubfoveal myopic CNV and good visual acuity, suggest that it may halt the progression of the disease in most cases.

摘要

目的

评估光动力疗法(PDT)治疗病理性近视(PM)相关的非黄斑中心凹下脉络膜新生血管(CNV)患者的视力及解剖学转归。

设计

干预性、非对照病例系列研究。

方法

97例患者(100只眼)在三个中心接受PDT治疗,并随访3至44个月(平均16.5个月)。观察指标为视力、病变大小及黄斑中心凹下侵犯情况。

结果

基线视力中位数为20/40(-2),范围为20/20至20/160(+2)。平均而言,在3至6个月视力适度提高约0.5行后,随访期间视力保持稳定。在第二年,视力下降3行或更多行的概率为10%至15%。首次PDT后病变大小(中位数:710微米)略有减小,随后有增大趋势,但与基线相比无统计学显著差异。第二年黄斑中心凹下CNV发生概率稳定在10%。第一年每位患者平均接受PDT治疗2.9次,第二年为0.6次。

结论

在这一大组非黄斑中心凹下近视性CNV且视力良好的患者中,PDT的视力及解剖学转归表明,在大多数情况下它可能会阻止疾病进展。

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