Department of Ophthalmology, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, Korea.
Ophthalmologica. 2011;225(3):169-75. doi: 10.1159/000323811. Epub 2011 Jan 27.
BACKGROUND/AIMS: To evaluate the efficacy of photodynamic therapy (PDT) combined with intravitreal injection of anti-vascular-endothelial-growth-factor (anti-VEGF) antibody in patients with polypoidal choroidal vasculopathy (PCV).
Twenty-two eyes of 22 patients with PCV followed for 12 months after combination therapy with PDT and anti-VEGF were retrospectively reviewed. Patients received intravitreal anti-VEGF (1.25 mg bevacizumab or 0.5 mg ranibizumab) within 7 days after PDT. Retreatment with PDT and intravitreal anti-VEGF injections, or with intravitreal anti-VEGF alone, was performed when indicated. The main outcome measures were best-corrected visual acuity (BCVA) and central foveal thickness (CFT).
Mean logMAR BCVA was 0.43 at baseline and 0.45, 0.36, 0.30 and 0.28 at 1, 3, 6 and 12 months, respectively, after the initial combination therapy. Mean BCVA was significantly improved at 6 and 12 months after treatment (p < 0.05). Mean CFT was 269.4 μm at baseline and 180.1, 136.7, 127.5 and 139.6 μm at 1, 3, 6 and 12 months, respectively, after the initial combination therapy. CFT decreased significantly throughout the follow-up period. At 12 months, mean BCVA improved by 1.5 lines, and mean CFT decreased by 129.8 μm. Polypoidal lesions disappeared in 7 of the 13 eyes in which indocyanine green angiography was performed at 12 months. No changes in the branching vascular network were observed in any of these 13 eyes. Patients were treated with PDT a mean of 1.3 times and injected with intravitreal anti-VEGF a mean of 3.4 times over the 12-month period.
Combined PDT and intravitreal anti-VEGF may improve visual acuity and decrease CFT at 12 months. Large long-term prospective studies are needed to evaluate the efficacy and safety of combination therapy.
背景/目的：评估光动力疗法（PDT）联合抗血管内皮生长因子（anti-VEGF）抗体眼内注射治疗息肉状脉络膜血管病变（PCV）的疗效。
回顾性分析 22 例 22 眼 PCV 患者，这些患者在 PDT 联合抗 VEGF 治疗后随访 12 个月。患者在 PDT 后 7 天内接受抗 VEGF 眼内注射（1.25mg 贝伐单抗或 0.5mg 雷珠单抗）。当需要时，进行 PDT 和眼内抗 VEGF 注射的再治疗，或仅进行眼内抗 VEGF 注射的再治疗。主要观察指标为最佳矫正视力（BCVA）和中心凹视网膜厚度（CFT）。
初始联合治疗后，平均 logMAR BCVA 分别为基线时的 0.43、1 个月时的 0.45、3 个月时的 0.36、6 个月时的 0.30 和 12 个月时的 0.28。治疗后 6 个月和 12 个月时，平均 BCVA 显著提高（p<0.05）。平均 CFT 分别为基线时的 269.4μm、1 个月时的 180.1μm、3 个月时的 136.7μm、6 个月时的 127.5μm 和 12 个月时的 139.6μm。整个随访期间 CFT 显著降低。12 个月时，平均 BCVA 提高 1.5 行，平均 CFT 降低 129.8μm。13 只眼行吲哚青绿血管造影检查，其中 7 只眼 12 个月时息肉状病变消失。这些眼中没有观察到分支血管网的变化。在 12 个月期间，患者平均接受 PDT 治疗 1.3 次，平均接受眼内抗 VEGF 注射 3.4 次。
联合 PDT 和眼内抗 VEGF 治疗可在 12 个月时提高视力并降低 CFT。需要进行大型长期前瞻性研究来评估联合治疗的疗效和安全性。
