Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China.
J Ocul Pharmacol Ther. 2010 Feb;26(1):91-5. doi: 10.1089/jop.2009.0073.
To evaluate the outcome of verteporfin photodynamic therapy (PDT) with or without intravitreal triamcinolone acetonide (IVTA) for the treatment of symptomatic polypoidal choroidal vasculopathy (PCV).
Retrospective analysis of PCV patients who underwent PDT with or without IVTA with follow-up of 2 or more years. Changes in best-corrected visual acuity (BCVA), proportion of eyes with moderate visual loss (3 or more lines), and complications were compared between patients with or without IVTA.
Twenty-seven eyes of 27 patients were analyzed, with 12 eyes treated by PDT monotherapy and 15 eyes treated by combined PDT with IVTA. The baseline characteristics of both groups were similar. At 1 year, the mean logMAR BCVA for the PDT monotherapy group improved from 0.74 to 0.58 (P = 0.011), whereas the combined PDT and IVTA group improved from 0.84 to 0.74 (P = 0.17). At 2 years, the mean logMAR BCVA for the monotherapy and combined treatment groups were 0.62 and 0.84, respectively, and the changes compared with baseline were not statistically significant. No significant difference was found in the mean logMAR BCVA, the mean line of visual changes, and the mean number of PDT treatments between the 2 groups at 1 and 2 years. One (8.3%) and 4 (26.7%) eyes in the monotherapy and the combined groups lost 3 or more lines at 2 years, respectively. Patients who had combined PDT with IVTA were more likely to develop cataract requiring surgery and ocular hypertension (P = 0.043 and 0.046, respectively).
PDT reduced the risks of visual loss in patients with symptomatic PCV in the short term but the effect might not be sustained after 1 year. The adjunctive use of IVTA during PDT did not appear to result in additional benefit for treating PCV.
评估单纯光动力疗法（PDT）与 PDT 联合玻璃体内曲安奈德（IVTA）治疗有症状息肉状脉络膜血管病变（PCV）的疗效。
回顾性分析了接受 PDT 联合或不联合 IVTA 治疗且随访时间超过 2 年的 PCV 患者。比较了单纯 PDT 治疗组和 PDT 联合 IVTA 治疗组患者之间最佳矫正视力（BCVA）变化、中度视力丧失（3 行以上）比例和并发症。
共分析了 27 例 27 只眼，其中 12 只眼接受单纯 PDT 治疗，15 只眼接受 PDT 联合 IVTA 治疗。两组患者的基线特征相似。1 年时，单纯 PDT 治疗组的平均对数视力 BCVA 从 0.74 提高到 0.58（P = 0.011），而 PDT 联合 IVTA 组则从 0.84 提高到 0.74（P = 0.17）。2 年时，单纯治疗组和联合治疗组的平均对数视力 BCVA 分别为 0.62 和 0.84，与基线相比变化无统计学意义。两组在 1 年和 2 年时的平均对数视力 BCVA、平均视力变化线和平均 PDT 治疗次数均无显著差异。单纯治疗组和联合治疗组分别有 1 只（8.3%）和 4 只（26.7%）眼在 2 年内视力丧失 3 行以上。联合 PDT 联合 IVTA 治疗的患者更有可能发生需要手术的白内障和眼高压（P = 0.043 和 0.046）。
PDT 可降低有症状 PCV 患者短期内视力丧失的风险，但 1 年后效果可能无法持续。在 PDT 期间联合使用 IVTA 似乎对治疗 PCV 没有额外益处。
