Honda Shigeru, Imai Hisanori, Yamashiro Kenji, Kurimoto Yasuo, Kanamori-Matsui Noriko, Kagotani Yasuaki, Tamura Yasushi, Yamamoto Hiroyuki, Ohoto Sotaro, Takagi Hitoshi, Uenishi Mamoru, Negi Akira
Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan.
Ophthalmologica. 2009;223(5):333-8. doi: 10.1159/000221837. Epub 2009 May 29.
PURPOSE: We aimed to evaluate the effects of photodynamic therapy (PDT) on different phenotypes of age-related macular degenerations (AMD): typical AMD (tAMD) and polypoidal choroidal vasculopathy (PCV). PROCEDURES: 246 eyes from 242 patients (tAMD: 139, PCV: 107 eyes) were recruited. Gender, age, best-corrected visual acuity (BCVA) before treatment, greatest linear dimension before treatment, lesion phenotype and PDT frequency were evaluated for predicting the BCVA at 12 months after PDT using stepwise multiple regression analyses. Additionally, 125 eyes with tAMD and 97 eyes with PCV followed up for more than 12 months after the final PDT were compared for the recurrence period. RESULTS: In the stepwise analysis, a younger age, better pretreatment BCVA, lower PDT frequency, lesions with PCV and a smaller pretreatment greatest linear dimension were all significantly beneficial for a better BCVA at 12 months after PDT. PCV showed a significantly lower PDT frequency and greater improvement in the BCVA than tAMD. The recurrence period of PCV was significantly later than that of tAMD. CONCLUSIONS: The phenotype of AMD is significantly correlated with its prognosis after PDT. PCV showed a significantly better response to PDT in terms of BCVA improvement and effect durability.
目的:我们旨在评估光动力疗法(PDT)对年龄相关性黄斑变性(AMD)不同表型的影响:典型AMD(tAMD)和息肉样脉络膜血管病变(PCV)。 程序:招募了来自242例患者的246只眼(tAMD:139只,PCV:107只眼)。使用逐步多元回归分析评估性别、年龄、治疗前最佳矫正视力(BCVA)、治疗前最大线性尺寸、病变表型和PDT频率,以预测PDT后12个月时的BCVA。此外,对最终PDT后随访超过12个月的125只tAMD眼和97只PCV眼的复发期进行了比较。 结果:在逐步分析中,年龄较小、治疗前BCVA较好、PDT频率较低、PCV病变以及治疗前最大线性尺寸较小,均对PDT后12个月时获得更好的BCVA有显著益处。PCV的PDT频率显著低于tAMD,且BCVA改善程度更大。PCV的复发期显著晚于tAMD。 结论:AMD的表型与其PDT后的预后显著相关。在BCVA改善和疗效持久性方面,PCV对PDT的反应显著更好。
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