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光动力疗法治疗典型的年龄相关性黄斑变性和息肉样脉络膜血管病变:日本兵库县的一项 30 个月的多中心研究。

Photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a 30-month multicenter study in Hyogo, Japan.

机构信息

Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan.

Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.

出版信息

Jpn J Ophthalmol. 2009 Nov;53(6):593-597. doi: 10.1007/s10384-009-0741-0. Epub 2009 Dec 18.


DOI:10.1007/s10384-009-0741-0
PMID:20020237
Abstract

PURPOSE: To evaluate the long-term effects of photodynamic therapy (PDT) on different phenotypes of age-related macular degeneration (AMD): typical AMD (tAMD) and polypoidal choroidal vasculopathy (PCV). METHODS: A multicenter prospective study of 207 eyes of 201 patients (tAMD, 123 eyes; PCV, 84 eyes) treated with PDT. Sex, age, best-corrected visual acuity (BCVA), greatest linear dimension, and lesion type were evaluated for pretreatment factors. PDT frequency, BCVA at 30 months post-PDT, frequency of recurrence, and mean recurrence period were compared as posttreatment outcomes. RESULTS: The 30 months post-PDT mean BCVA was significantly lower than the pre-PDT value in the tAMD group, but it remained unchanged in the PCV group. There was no difference in PDT frequency between the two groups. Multivariate analysis revealed that lesion type was the only predicting factor significantly associated with BCVA at 30 months post-PDT. The incidence of recurrence before 30 months post-PDT was not significantly different between the tAMD and PCV groups, whereas the mean duration of the PDT effect was significantly longer in the PCV group than in the tAMD group. CONCLUSIONS: PDT may have some advantages for PCV patients, but not for tAMD patients. However, as PCV often recurred 12 months post-PDT, long-term observation after the treatment is crucial.

摘要

目的:评估光动力疗法(PDT)对不同表型年龄相关性黄斑变性(AMD)的长期效果:典型 AMD(tAMD)和息肉样脉络膜血管病变(PCV)。 方法:对 201 例 207 只眼(tAMD123 只眼,PCV84 只眼)进行 PDT 的多中心前瞻性研究。对治疗前的性别、年龄、最佳矫正视力(BCVA)、最大线性尺寸和病变类型等因素进行评估。比较 PDT 频率、治疗后 30 个月的 BCVA、复发频率和平均复发时间等治疗后结果。 结果:治疗后 30 个月的 tAMD 组平均 BCVA 明显低于治疗前,而 PCV 组则保持不变。两组 PDT 频率无差异。多变量分析显示,病变类型是与治疗后 30 个月 BCVA 唯一显著相关的预测因素。tAMD 和 PCV 两组在治疗后 30 个月前的复发率无显著差异,但 PCV 组 PDT 效果的平均持续时间明显长于 tAMD 组。 结论:PDT 对 PCV 患者可能有一些优势,但对 tAMD 患者没有。然而,由于 PCV 常在 PDT 后 12 个月复发,因此治疗后的长期观察至关重要。

相似文献

[1]
Photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a 30-month multicenter study in Hyogo, Japan.

Jpn J Ophthalmol. 2009-12-18

[2]
Comparative assessment of photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a multicenter study in Hyogo prefecture, Japan.

Ophthalmologica. 2009

[3]
Visual outcome of photodynamic therapy for typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy over 5 years of follow-up.

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[4]
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[5]
The association of age-related maculopathy susceptibility 2 polymorphisms with phenotype in typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy.

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[6]
Factors influencing visual outcome of polypoidal choroidal vasculopathy one year after photodynamic therapy.

Graefes Arch Clin Exp Ophthalmol. 2010-3-30

[7]
[Polypoidal choroidal vasculopathy].

Nippon Ganka Gakkai Zasshi. 2012-3

[8]
Real-World Treatment Outcomes of Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy in Asians.

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[9]
Two-year results of reduced-fluence photodynamic therapy combined with intravitreal ranibizumab for typical age-related macular degeneration and polypoidal choroidal vasculopathy.

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[10]
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引用本文的文献

[1]
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[2]
Polypoidal choroidal vasculopathy: An update on current management and review of literature.

Taiwan J Ophthalmol. 2019

[3]
The Use of Vascular Endothelial Growth Factor Inhibitors and Complementary Treatment Options in Polypoidal Choroidal Vasculopathy: A Subtype of Neovascular Age-Related Macular Degeneration.

Int J Mol Sci. 2018-9-3

[4]
Comparison of the effects of photodynamic therapy, intravitreal ranibizumab and combination for polypoidal choroidal vasculopathy under 1 + PRN regimen.

BMC Ophthalmol. 2018-6-20

[5]
Prevalence and treatment patterns of ranibizumab and photodynamic therapy in a tertiary care setting in Malaysia.

Int J Ophthalmol. 2017-12-18

[6]
HTRA1 promoter variant differentiates polypoidal choroidal vasculopathy from exudative age-related macular degeneration.

Sci Rep. 2016-6-24

[7]
Polypoidal Choroidal Vasculopathy in Asians.

J Clin Med. 2015-4-24

[8]
Five-year results of photodynamic therapy with verteporfin for Japanese patients with neovascular age-related macular degeneration.

Clin Ophthalmol. 2013

[9]
Effectiveness of intravitreal ranibizumab in exudative age-related macular degeneration (AMD): comparison between typical neovascular AMD and polypoidal choroidal vasculopathy over a 1 year follow-up.

BMC Ophthalmol. 2013-4-4

[10]
Visual outcome of photodynamic therapy for typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy over 5 years of follow-up.

Jpn J Ophthalmol. 2013-3-19

本文引用的文献

[1]
Comparative assessment of photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a multicenter study in Hyogo prefecture, Japan.

Ophthalmologica. 2009

[2]
Forecasting age-related macular degeneration through the year 2050: the potential impact of new treatments.

Arch Ophthalmol. 2009-4

[3]
Coding variant I62V in the complement factor H gene is strongly associated with polypoidal choroidal vasculopathy.

Ophthalmology. 2009-2

[4]
Two-year results of photodynamic therapy for polypoidal choroidal vasculopathy.

Am J Ophthalmol. 2008-10

[5]
Age-related macular degeneration: diagnosis and management.

Br Med Bull. 2008

[6]
Elastin gene polymorphisms in neovascular age-related macular degeneration and polypoidal choroidal vasculopathy.

Invest Ophthalmol Vis Sci. 2008-3

[7]
Single-session photodynamic therapy combined with intravitreal bevacizumab for neovascular age-related macular degeneration.

Eur J Ophthalmol. 2008

[8]
Anti-VEGF agents in the treatment of neovascular age-related macular degeneration: applying clinical trial results to the treatment of everyday patients.

Am J Ophthalmol. 2007-10

[9]
Intravitreal bevacizumab in the treatment of neovascular age-related macular degeneration, 6- and 9-month results.

Eye (Lond). 2008-1

[10]
Combined intravitreal bevacizumab and photodynamic therapy for neovascular age-related macular degeneration.

Graefes Arch Clin Exp Ophthalmol. 2008-1

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