Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Graefes Arch Clin Exp Ophthalmol. 2013 Apr;251(4):1073-80. doi: 10.1007/s00417-012-2137-y. Epub 2012 Aug 25.
To compare the 2-year results after photodynamic therapy (PDT) alone and PDT combined with intravitreal injections of bevacizumab and triamcinolone acetonide (triple therapy) for polypoidal choroidal vasculopathy (PCV).
We retrospectively reviewed the medical records of 40 consecutive patients (40 eyes) with subfoveal PCV. Of these 40 eyes, 16 were treated with PDT alone and 24 were treated with triple therapy.
The change in visual acuity in the triple therapy group was significantly better than that in the PDT group (P < 0.001). At 24 months, improvement in visual acuity was seen in only two eyes (12.5 %) of the PDT group, while it was seen in ten eyes (41.7 %) of the triple therapy group. Retreatment was given to 12 eyes (75.0 %) in the PDT group and to nine eyes (37.5 %) in the triple therapy group, although the retreatment-free period was significantly longer in the triple therapy group than in the PDT group (P < 0.001). Post-treatment vitreous hemorrhage was seen in only two eyes (12.5 %), all of which were in the PDT group.
Compared with PDT alone, triple therapy appears to reduce the postoperative hemorrhagic complications and recurrences of PCV and to improve the 2-year visual outcomes of PCV.
比较单纯光动力疗法（PDT）与 PDT 联合玻璃体内注射贝伐单抗和曲安奈德（三联疗法）治疗息肉状脉络膜血管病变（PCV）的 2 年疗效。
我们回顾性分析了 40 例（40 只眼）接受治疗的中心性浆液性脉络膜视网膜病变患者的病历。其中 16 只眼接受 PDT 治疗，24 只眼接受三联疗法治疗。
三联疗法组的视力变化明显优于 PDT 组（P < 0.001）。在 24 个月时，PDT 组只有 2 只眼（12.5%）视力提高，而三联疗法组有 10 只眼（41.7%）视力提高。PDT 组中有 12 只眼（75.0%）需要再次治疗，三联疗法组中有 9 只眼（37.5%）需要再次治疗，尽管三联疗法组的无治疗间期明显长于 PDT 组（P < 0.001）。治疗后仅 2 只眼（12.5%）出现玻璃体积血，均发生在 PDT 组。
与单纯 PDT 相比，三联疗法似乎可以减少 PCV 的术后出血并发症和复发，改善 PCV 的 2 年视力预后。
