Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan.
Am J Ophthalmol. 2011 Apr;151(4):594-603.e1. doi: 10.1016/j.ajo.2010.10.030. Epub 2011 Feb 4.
To evaluate the morphologic retinal and choroidal changes after verteporfin photodynamic therapy (PDT) with and without ranibizumab for polypoidal choroidal vasculopathy using spectral-domain optical coherence tomography.
Retrospective, comparative series.
The enhanced depth imaging optical coherence tomography technique was used in this retrospective, comparative series to measure the subfoveal retinal and choroidal thicknesses before and after treatment.
Twenty-seven eyes with polypoidal choroidal vasculopathy were examined retrospectively. Sixteen eyes were treated with PDT monotherapy (PDT group). Eleven eyes were treated with PDT after intravitreal ranibizumab injection (ranibizumab plus PDT group). The polypoidal lesions regressed in all cases at 3 months. The mean retinal thickness, including the retinal detachment, increased from 401 ± 157 μm before treatment to 506 ± 182 μm 2 days after PDT (P<.001) and decreased to 365 ± 116 μm by 1 week after treatment (P=.03) and 265 ± 127 μm by 6 months after treatment (P<.001). The mean choroidal thickness increased from 269 ± 107 μm before treatment to 336 ± 96 μm 2 days after PDT treatment (P < .001 compared with baseline) and decreased to 262 ± 96 μm by 1 week after treatment (P=.24) and 229 ± 104 μm by 6 months (P<.001). Although the choroidal thickness showed a similar trend with both therapies, the retinal thickness in the ranibizumab plus PDT group remained thinner than that in the PDT group until 6 months after treatment.
PDT was associated with decreased retinal and choroidal thicknesses. Combination therapy reduced the transient exudation after PDT in some cases, and monthly intravitreal ranibizumab injections maintained retinal thinning and seemed to improve vision better than PDT monotherapy.
使用频域光相干断层扫描评估光动力疗法（PDT）联合和不联合雷珠单抗治疗息肉状脉络膜血管病变后的形态视网膜和脉络膜变化。
回顾性比较系列。
本回顾性比较系列使用增强深度成像光相干断层扫描技术测量治疗前后的中心凹下视网膜和脉络膜厚度。
回顾性检查了 27 只患有息肉状脉络膜血管病变的眼睛。16 只眼睛接受 PDT 单一疗法（PDT 组）治疗。11 只眼睛接受玻璃体内雷珠单抗注射后 PDT 治疗（雷珠单抗联合 PDT 组）。所有病例的息肉状病变在 3 个月时均消退。包括视网膜脱离在内的平均视网膜厚度从治疗前的 401±157μm增加到 PDT 后 2 天的 506±182μm（P<.001），并在治疗后 1 周下降至 365±116μm（P=.03），治疗后 6 个月下降至 265±127μm（P<.001）。平均脉络膜厚度从治疗前的 269±107μm增加到 PDT 治疗后 2 天的 336±96μm（与基线相比，P<.001），并在治疗后 1 周下降至 262±96μm（P=.24），治疗后 6 个月下降至 229±104μm（P<.001）。虽然两种治疗方法的脉络膜厚度都呈现出相似的趋势，但雷珠单抗联合 PDT 组的视网膜厚度在治疗后 6 个月内仍比 PDT 组薄。
PDT 与视网膜和脉络膜厚度降低有关。联合治疗在某些情况下减少了 PDT 后的短暂渗出，每月玻璃体内雷珠单抗注射维持视网膜变薄，并似乎比 PDT 单一疗法更好地改善视力。
