Department of Ophthalmology, Inje University Seoul Paik Hospital, Seoul, Republic of Korea.
Ophthalmologica. 2011;226(4):205-13. doi: 10.1159/000330793. Epub 2011 Sep 1.
BACKGROUND/AIMS: To evaluate the 2-year efficacy of photodynamic therapy (PDT) combined with intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) in patients with polypoidal choroidal vasculopathy (PCV).
Twenty-two eyes of 22 patients with PCV followed up for ≥24 months after PDT and anti-VEGF combination therapy were retrospectively reviewed. The patients received intravitreal anti-VEGF (1.25 mg bevacizumab or 0.5 mg ranibizumab) within 7 days after PDT. Eyes were retreated with PDT and anti-VEGF injection, or with only anti-VEGF injection, when indicated. Main outcome measures were best-corrected visual acuity (BCVA) and central foveal thickness (CFT).
The mean baseline BCVA (0.43±0.33 logarithm of the minimum angle of resolution, logMAR) was 0.28±0.24 at 12 months (p<0.05 vs. baseline) and 0.39±0.28 at 24 months (not significant). At 24 months, BCVA improved by ≥0.3 logMAR in 27.3% of the eyes, did not significantly decrease in 59.1%, and decreased by ≥0.3 logMAR in 13.6%. The mean CFT was 269.4±134.5 μm at baseline and significantly decreased to 139.6±45.8 μm (12 months) and 199.6±72.9 μm (24 months). PDT was administered 1.45±0.86 times and anti-VEGF injected 4.45±1.36 times over the 24-month period.
Combined PDT and anti-VEGF injection were effective for 2 years in PCV patients. Visual acuity significantly improved during year 1, but the benefit diminished in year 2. Further investigations are required to determine how to prolong the therapeutic effect of combination therapy for PCV.
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）玻璃体腔内注射治疗息肉状脉络膜血管病变（PCV）的 2 年疗效。
回顾性分析 22 例（22 只眼）PCV 患者 PDT 联合抗 VEGF 治疗后随访时间≥24 个月的资料。PDT 后 7 天内给予患者玻璃体腔内注射抗 VEGF（1.25mg 贝伐单抗或 0.5mg 雷珠单抗）。根据需要行 PDT 和抗 VEGF 注射或仅行抗 VEGF 注射治疗。主要观察指标为最佳矫正视力（BCVA）和中心视网膜厚度（CFT）。
平均基线 BCVA（对数最小分辨角视力 logMAR ）为 0.43±0.33，治疗后 12 个月（p<0.05 与基线比较）和 24 个月（无统计学差异）分别为 0.28±0.24 和 0.39±0.28。24 个月时，27.3%的眼 BCVA 提高≥0.3 logMAR，59.1%的眼 BCVA 无显著下降，13.6%的眼 BCVA 下降≥0.3 logMAR。基线时平均 CFT 为 269.4±134.5μm，治疗后 12 个月和 24 个月时分别显著下降至 139.6±45.8μm 和 199.6±72.9μm。24 个月内 PDT 治疗 1.45±0.86 次，抗 VEGF 注射 4.45±1.36 次。
PDT 联合抗 VEGF 注射治疗 PCV 患者 2 年有效。视力在第 1 年显著改善，但第 2 年获益减少。需要进一步研究以确定如何延长 PCV 患者联合治疗的疗效。
