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两种方法治疗近视性脉络膜新生血管的两年比较:光动力疗法与玻璃体内注射贝伐单抗。

Two-year comparison of photodynamic therapy and intravitreal bevacizumab for treatment of myopic choroidal neovascularisation.

机构信息

Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chuo-ku, Chiba, Japan.

出版信息

Br J Ophthalmol. 2010 Jul;94(7):864-70. doi: 10.1136/bjo.2009.166025. Epub 2009 Dec 3.

Abstract

AIM

To compare the long-term outcome of photodynamic therapy (PDT) with that of intravitreal bevacizumab (IVB) for myopic choroidal neovascularizations (mCNVs).

METHODS

24 eyes were selected from 40 consecutive patients with mCNV, and the patients were divided into Group A, consisting of 12 eyes treated by PDT, and Group B, consisting of 12 eyes treated by 1.25 mg IVB. The age and best-corrected visual acuity (BCVA) were matched between the two groups. The BCVA, size of the chorioretinal atrophy surrounding the CNV (CRA), central foveal thickness (CFT) and CNV thickness were determined before and at 12 and 24 months after the treatment.

RESULTS

The BCVA did not change after PDT but was significantly improved from 0.75+/-0.25 to 0.49+/-0.42 logMAR units at 12 months and to 0.50+/-0.38 logMAR units at 24 months after IVB. The CFT were significantly reduced in both groups at 12 and 24 months. The CRAs were larger in group A than in group B at 12 and 24 months, and their sizes were correlated with the BCVA.

CONCLUSION

At 24 months, IVB is more effective than PDT in treating mCNV. The enlargement of the CRA might be related to the incomplete visual recovery after PDT.

摘要

目的

比较光动力疗法(PDT)与玻璃体内注射贝伐单抗(IVB)治疗近视性脉络膜新生血管(mCNV)的长期疗效。

方法

从 40 例连续 mCNV 患者中选取 24 只眼,分为 PDT 治疗的 A 组(n=12 只眼)和 IVB 治疗的 B 组(n=12 只眼)。两组年龄和最佳矫正视力(BCVA)相匹配。在治疗前和治疗后 12 个月和 24 个月时,评估 BCVA、CNV 周围脉络膜视网膜萎缩(CRA)大小、中心凹视网膜厚度(CFT)和 CNV 厚度。

结果

PDT 治疗后 BCVA 无变化,但 IVB 治疗后 12 个月从 0.75+/-0.25 显著提高至 0.49+/-0.42 logMAR 单位,24 个月时提高至 0.50+/-0.38 logMAR 单位。两组 CFT 在治疗后 12 个月和 24 个月时均显著降低。A 组在治疗后 12 个月和 24 个月时 CRA 均大于 B 组,且其大小与 BCVA 相关。

结论

24 个月时,IVB 治疗 mCNV 比 PDT 更有效。CRA 的增大可能与 PDT 后视力不完全恢复有关。

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