Nakano Saya, Honda Shigeru, Oh Hideyasu, Kita Mihori, Negi Akira
Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe.
Clin Ophthalmol. 2012;6:277-82. doi: 10.2147/OPTH.S29718. Epub 2012 Feb 20.
The purpose of this work was to compare the efficacy of photodynamic therapy (PDT) with or without posterior subtenon injections of triamcinolone acetonide (STA) or intravitreal injections of ranibizumab (IVR) for retinal angiomatous proliferation (RAP).
Thirty-seven eyes from 33 consecutive patients with RAP were treated by PDT monotherapy (Group 1), PDT combined with STA (Group 2), or PDT combined with IVR (Group 3). The best-corrected visual acuity, greatest linear dimension, central retinal thickness, and number of treatments were compared among the three groups.
The change in mean best-corrected visual acuity (logMAR) at month 3, 6, and 12 after the initial treatment was better in Group 2 (-0.13, -0.23, and -0.21, respectively) and Group 3 (-0.018, 0.0028, and -0.0067, respectively) than in Group 1 (0.13, 0.19, and 0.23, respectively); Group 1 versus Group 2 was statistically significant (P = 0.018). The mean central retinal thickness was reduced from baseline in all groups, but the reduction amplitude was significantly greater in Group 2 than in Group 1 and Group 3. The mean number of treatments was significantly lower in Group 2 (1.1 ± 0.4) and Group 3 (1.5 ± 0.5) than in Group 1 (2.9 ± 0.9) in the 12 months after the initial treatment.
Treatment with STA + PDT may be an effective therapy for RAP lesions over 12 months of follow-up.
本研究旨在比较光动力疗法(PDT)联合或不联合后Tenon囊下注射曲安奈德(STA)或玻璃体腔内注射雷珠单抗(IVR)治疗视网膜血管瘤样增生(RAP)的疗效。
对33例连续的RAP患者的37只眼进行治疗,其中光动力疗法单一治疗(第1组),光动力疗法联合STA(第2组),或光动力疗法联合IVR(第3组)。比较三组的最佳矫正视力、最大线性尺寸、中心视网膜厚度和治疗次数。
初始治疗后第3、6和12个月时,第2组(分别为-0.13、-0.23和-0.21)和第3组(分别为-0.018、0.0028和-0.0067)的平均最佳矫正视力(logMAR)变化优于第1组(分别为0.13、0.19和0.23);第1组与第2组相比差异有统计学意义(P = 0.018)。所有组的中心视网膜厚度均较基线降低,但第2组的降低幅度明显大于第1组和第3组。初始治疗后12个月内,第2组(1.1±0.4)和第3组(1.5±0.5)的平均治疗次数明显低于第1组(2.9±0.9)。
在12个月的随访中,STA+PDT治疗可能是治疗RAP病变的有效方法。