Ohtsuka Eye Hospital, Sapporo, Japan.
Retina. 2011 May;31(5):857-65. doi: 10.1097/IAE.0b013e3181fecda9.
The purpose of this study was to determine the factors predictive of visual acuity (VA) outcomes 1 year after photodynamic therapy (PDT) for polypoidal choroidal vasculopathy.
We prospectively studied 220 eyes of 210 Japanese patients with polypoidal choroidal vasculopathy treated with primary application of PDT. A stepwise logistic regression model was used to estimate the independent factors predictive of better VA and improvement of VA 1 year after the primary PDT.
Visual acuities at the various follow-up evaluations improved significantly compared with baseline (P = 0.001 for all comparisons). The VA improved and decreased more than 0.3 logarithm of minimum angle of resolution unit 1 year after the primary PDT in 55 (25%) and 21 (10%) eyes, respectively. Stepwise logistic regression analysis showed that younger age, smaller greatest linear dimension, better baseline VA, and less baseline hemorrhage were significant and independent factors predictive of better VA 1 year after PDT, and younger age, smaller greatest linear dimension, better baseline VA, less hemorrhaging, and the presence of a serous macular detachment at baseline were significant and independent factors predictive of VA improvement.
Photodynamic therapy stabilized eyes anatomically and functionally. Clinical characteristics at baseline were predictors of favorable VA outcomes after PDT. These findings may help establish the strategy of treatment for polypoidal choroidal vasculopathy.
本研究旨在确定光动力疗法(PDT)治疗息肉状脉络膜血管病变 1 年后预测视力(VA)结果的相关因素。
我们前瞻性研究了 210 例 220 只眼的日本息肉状脉络膜血管病变患者,这些患者均接受了原发性 PDT 治疗。采用逐步逻辑回归模型来评估预测原发性 PDT 治疗后 1 年 VA 更好和 VA 改善的独立因素。
与基线相比,各随访评估时的视力均显著提高(所有比较的 P = 0.001)。在原发性 PDT 治疗后 1 年,VA 改善超过 0.3 个最小分辨角对数单位的眼分别有 55 只(25%)和 21 只(10%),VA 下降超过 0.3 个最小分辨角对数单位的眼分别有 14 只(6.7%)和 5 只(2.4%)。逐步逻辑回归分析显示,年龄较小、最大线性尺寸较小、基线 VA 较好和基线出血较少是 PDT 治疗后 1 年 VA 更好的重要且独立的预测因素,而年龄较小、最大线性尺寸较小、基线 VA 较好、出血较少和基线存在浆液性黄斑脱离是 VA 改善的重要且独立的预测因素。
PDT 在解剖学和功能上稳定了眼睛。基线时的临床特征是 PDT 治疗后 VA 结果良好的预测因素。这些发现可能有助于确定息肉状脉络膜血管病变的治疗策略。