Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.
Am J Ophthalmol. 2010 Nov;150(5):710-715.e1. doi: 10.1016/j.ajo.2010.05.016. Epub 2010 Aug 14.
To evaluate the efficacy and safety of photodynamic therapy (PDT) for macular circumscribed choroidal hemangioma in Chinese patients.
Retrospective, consecutive, noncomparative case series.
Twenty-five eyes (25 patients) with macular circumscribed choroidal hemangioma, 18 subfoveal and 7 perifoveal, with vision impairment attributable to subfoveal fluid and retinal detachment underwent visual acuity testing, fundus fluorescein angiography, ultrasonography, and optical coherence tomography (OCT) examinations to evaluate the efficacy and safety of PDT treatment. PDT was performed with a standard concentration of verteporfin and intravenous injection time. Laser was used at 50 J/cm² for 83 seconds on subfoveal and 75 J/cm² for 125 seconds on perifoveal lesions. More than 1 spot was used for large lesions and spots overlapped only outside the fovea.
The mean follow-up time was 35.5 ± 15 months. All patients were treated with 1 session except in 2 subfoveal cases. The mean best-corrected visual acuity (BCVA) increased from 0.09 ± 0.11 to 0.31 ± 0.37 (P < .01) and 11 patients (44%) had their vision improve over 4 lines. The remaining 14 patients (56%) had stabilized vision with the retina reattached. The mean thickness of the hemangioma before the treatment was 3.2 ± 0.9 mm and decreased to 1.3 ± 1.0 mm post treatment (P < .01), with complete regression of tumor in 7 cases (28%).
PDT with individualized laser parameters for macular circumscribed choroidal hemangioma is effective and safe, leading to improved or stabilized BCVA as a result of tumor shrinkage and the resolution of the subretinal fluid.
评估光动力疗法(PDT)治疗中国患者黄斑局限型脉络膜血管瘤的疗效和安全性。
回顾性、连续、非对照病例系列。
25 只眼(25 例)黄斑局限型脉络膜血管瘤,18 只位于黄斑下,7 只位于黄斑旁,因黄斑下积液和视网膜脱离导致视力损害,行视力检查、眼底荧光素血管造影、超声检查和光学相干断层扫描(OCT)检查,评估 PDT 治疗的疗效和安全性。PDT 采用标准浓度的维替泊芬和静脉注射时间。黄斑下病变用 50J/cm²激光照射 83 秒,黄斑旁病变用 75J/cm²激光照射 125 秒。对于大病变,使用多个光斑,光斑仅在黄斑外重叠。
平均随访时间为 35.5±15 个月。除 2 例黄斑下病变外,所有患者均接受 1 次治疗。平均最佳矫正视力(BCVA)从 0.09±0.11 提高到 0.31±0.37(P<.01),11 例(44%)视力提高超过 4 行。其余 14 例(56%)视力稳定,视网膜复位。治疗前血管瘤平均厚度为 3.2±0.9mm,治疗后降至 1.3±1.0mm(P<.01),7 例(28%)肿瘤完全消退。
针对黄斑局限型脉络膜血管瘤的个体化激光参数 PDT 是有效和安全的,可缩小肿瘤体积,消退视网膜下积液,从而提高或稳定 BCVA。