Saito M, Iida T, Nagayama D
Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan.
Br J Ophthalmol. 2008 Dec;92(12):1642-7. doi: 10.1136/bjo.2007.137075. Epub 2008 Sep 9.
To evaluate outcomes after photodynamic therapy (PDT) with verteporfin in Japanese patients with age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy (PCV) and compare results with the presence/absence of a retinal pigment epithelial detachment (PED).
We retrospectively reviewed 183 eyes with subfoveal choroidal neovascularisation secondary to AMD with more than 3 months' follow-up (range 3 to 36; mean 15.6). A serous PED developed in 44 of 183 eyes.
A total of 124 eyes (67.8%) completed 12 months' follow-up. In 49 eyes with typical AMD, the best-corrected visual acuity (BCVA) improved a mean of 0.48 line. A significant (p<0.05 to p<0.0005) decline in VA occurred in eyes with a serous PED during any 3-month period. In 75 eyes with PCV, the BCVA at 12 months improved a mean of 1.79 lines. There was no significant difference between the BCVA in 22 eyes with a PED and 53 eyes without a PED during any 3 months.
In eyes with typical AMD, a serous PED was associated with a significant decline in BCVA compared with eyes without a serous PED. In eyes with PCV, the visual outcomes were unaffected by a serous PED. When PDT is administered, differentiating PCV from typical AMD using indocyanine green angiography is important.
评估日本年龄相关性黄斑变性(AMD)或息肉样脉络膜血管病变(PCV)患者接受维替泊芬光动力疗法(PDT)后的疗效,并比较有无视网膜色素上皮脱离(PED)时的结果。
我们回顾性分析了183只继发于AMD的黄斑下脉络膜新生血管眼,随访时间超过3个月(范围3至36个月;平均15.6个月)。183只眼中有44只出现了浆液性PED。
共有124只眼(67.8%)完成了12个月的随访。在49只典型AMD眼中,最佳矫正视力(BCVA)平均提高了0.48行。在任何3个月期间,有浆液性PED的眼中视力均出现显著(p<0.05至p<0.0005)下降。在75只PCV眼中,12个月时的BCVA平均提高了1.79行。在任何3个月期间,22只伴有PED的眼和53只不伴有PED的眼的BCVA之间无显著差异。
在典型AMD眼中,与无浆液性PED的眼相比,浆液性PED与BCVA显著下降相关。在PCV眼中,浆液性PED不影响视觉结果。进行PDT时,使用吲哚菁绿血管造影将PCV与典型AMD区分开来很重要。