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少能量频域光动力疗法治疗息肉状脉络膜血管病变的两年结果。

Two-year results of reduced-fluence photodynamic therapy for polypoidal choroidal vasculopathy.

机构信息

Department of Ophthalmology, Kagawa University Faculty of Medicine, Kagawa, Japan.

出版信息

Am J Ophthalmol. 2013 Jan;155(1):96-102.e1. doi: 10.1016/j.ajo.2012.06.027. Epub 2012 Sep 18.

Abstract

PURPOSE

To report the results of a 2-year follow-up study of Japanese polypoidal choroidal vasculopathy (PCV) patients treated with reduced-fluence photodynamic therapy (PDT) monotherapy.

DESIGN

Prospective interventional case series.

METHODS

In the present study, 38 eyes of 38 consecutive patients underwent PDT with a reduced laser fluence of 25 J/cm(2). During the 2-year follow-up, visual acuity (VA) and optical coherence tomography measurements were performed every 3 months after the PDT procedure and then compared with baseline values. PCV vascular lesions were evaluated by indocyanine green and fluorescein angiography.

RESULTS

At baseline, the mean logarithm of the minimal angle of resolution (logMAR) best-corrected VA (BCVA) was 0.43. There was a significant improvement of the mean logMAR BCVA to 0.28 and 0.29 at 12 and 24 months, respectively (P < .0001, P = .001). The logMAR BCVA was stable or improved by ≥0.3 in 36 (95%) of the eyes at the 2-year follow-up. In 13 eyes in which the baseline VA was better than 20/40, there was a significant improvement of the mean logMAR BCVA at 12 months, with the acuities continuing to be stable at 24 months. The mean number of treatment sessions during the 24-month study period was 1.9.

CONCLUSIONS

Reduced-fluence PDT monotherapy for PCV effectively improved and maintained the VA over a 24-month period, even in eyes with a baseline VA better than 20/40. In addition, the number of treatments could be much smaller as compared with intravitreal injection of anti-vascular endothelial growth factor agents.

摘要

目的

报告 2 年随访研究结果,该研究评估了接受低强度光动力疗法(PDT)单药治疗的日本息肉状脉络膜血管病变(PCV)患者的疗效。

设计

前瞻性干预性病例系列研究。

方法

本研究纳入 38 例(38 只眼)连续 PCV 患者,所有患者均接受 25 J/cm²低强度 PDT 治疗。在 2 年的随访期间,于 PDT 术后每 3 个月进行视力(VA)和光学相干断层扫描(OCT)测量,并与基线值进行比较。采用吲哚青绿和荧光素血管造影评估 PCV 血管病变。

结果

基线时,最佳矫正视力(BCVA)的最小分辨角对数(logMAR)平均值为 0.43。在 12 个月和 24 个月时,平均 logMAR BCVA 分别显著提高至 0.28 和 0.29(P<0.0001,P=0.001)。在 2 年随访时,36 只(95%)眼的 BCVA 稳定或提高≥0.3。在基线 VA 优于 20/40 的 13 只眼中,12 个月时平均 logMAR BCVA 显著提高,24 个月时视力持续稳定。在 24 个月的研究期间,平均治疗次数为 1.9 次。

结论

对于 PCV,低强度 PDT 单药治疗可在 24 个月内有效改善和维持 VA,即使在基线 VA 优于 20/40 的眼中也是如此。此外,与玻璃体内注射抗血管内皮生长因子药物相比,治疗次数可能要少得多。

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