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