Department of Ophthalmology, Nihon University Surugadai Hospital, Tokyo, Japan.
Jpn J Ophthalmol. 2011 Jan;55(1):39-44. doi: 10.1007/s10384-010-0886-x. Epub 2011 Feb 18.
To evaluate the visual outcomes and changes in abnormal vascular networks and polypoidal lesions of polypoidal choroidal vasculopathy (PCV) 3 years after photodynamic therapy (PDT).
We studied 43 eyes of 43 patients with PCV for 3 years. Fundus appearance, fluorescein angiography (FA) and indocyanine green angiography (IA) findings, and visual acuity (VA) before the initial PDT were compared with those 3 months, 1 year, 2 years, and 3 years after treatment.
In 24 of the 43 eyes, enlargement of the abnormal vascular network continued in a manner similar to that before PDT on IA; in eight eyes, transformation into polypoidal choroidal neovascularization (CNV) with enlargement was detected; and two eyes had the appearance of classic CNV on FA. Polypoidal lesions recurred at 3 years in 33 of the 43 eyes (77%). Mean VA (logarithm of the minimum angle of resolution) of all 43 eyes decreased to below baseline at 3 years after the initial PDT. This decrease can be explained by foveal atrophy after absorption of recurrent hemorrhagic or exudative detachment.
Long-term visual outcomes were not good owing to the high frequency of recurrent polypoidal lesions, as well as enlargement and neovascular changes involving abnormal vascular networks.
评估 3 年后光动力疗法（PDT）后息肉状脉络膜血管病变（PCV）异常血管网络和息肉样病变的视觉结果和变化。
我们对 43 例 PCV 患者的 43 只眼进行了 3 年的研究。比较了初始 PDT 前、治疗后 3 个月、1 年、2 年和 3 年的眼底表现、荧光素血管造影（FA）和吲哚青绿血管造影（IA）结果以及视力（VA）。
在 43 只眼中的 24 只眼中，IA 上异常血管网络的扩大以类似于 PDT 前的方式继续；在 8 只眼中，检测到扩大的息肉状脉络膜新生血管化（CNV）的转化；2 只眼 FA 上出现典型 CNV 的外观。在 43 只眼中，33 只眼（77%）在 3 年内息肉样病变复发。所有 43 只眼的平均 VA（最小分辨角对数）在初始 PDT 后 3 年降至基线以下。这种下降可以用复发性出血或渗出性脱离吸收后的黄斑萎缩来解释。
由于息肉样病变的高复发率以及异常血管网络的扩大和新生血管变化，长期视觉结果不佳。
