Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan.
Jpn J Ophthalmol. 2013 Mar;57(2):211-20. doi: 10.1007/s10384-012-0215-7. Epub 2012 Dec 4.
To clarify the efficacy of a combination of intravitreal anti-vascular endothelial growth factor (VEGF) injections and photodynamic therapy (PDT), over 24 months, for patients with symptomatic retinal angiomatous proliferation (RAP).
We retrospectively reviewed 13 treatment-naïve eyes of 12 patients (7 men, 5 women; age range (mean), 63-92 (77) years) treated with intravitreal bevacizumab (IVB) plus PDT as initial treatment. Retreatment was performed with IVB plus PDT until February 2009 or intravitreal ranibizumab and PDT from March 2009.
Mean best-corrected visual acuity (BCVA) significantly improved from 0.26 at baseline to 0.40 at 24 months (P = 0.013). The mean improvement in BCVA at 24 months from baseline was 1.79 lines. The central retinal thickness decreased significantly from 431 to 142 microns at 24 months (P < 0.0001). Complete occlusion of the retinal-retinal anastomosis was achieved in seven of the 10 eyes at 24 months. The mean number of PDT treatments during 24 months was 2.8 and the mean number of injections was 3.4. Geographic atrophy was seen in four eyes without significant decline of VA at 24 months.
Combined anti-VEGF and PDT for RAP patients effectively maintained or improved VA and reduced exudation, without severe adverse events, over 24 months.
明确在 24 个月内，对伴有症状性视网膜毛细血管瘤样增生（RAP）的患者，采用抗血管内皮生长因子（VEGF）联合玻璃体腔内注射（IVB）和光动力疗法（PDT）的疗效。
我们回顾性分析了 12 例（7 名男性，5 名女性；年龄范围（均值），63-92 岁）13 只未经治疗的眼，采用 IVB 联合 PDT 作为初始治疗。从 2009 年 3 月开始，对复发性患者采用 IVB 联合 PDT 或玻璃体腔内雷珠单抗联合 PDT 进行治疗。
最佳矫正视力（BCVA）从基线时的 0.26 提高到 24 个月时的 0.40（P=0.013）。24 个月时 BCVA 从基线时的平均改善为 1.79 行。视网膜-视网膜吻合处的中心视网膜厚度从 24 个月时的 431 微米显著降低至 142 微米（P<0.0001）。在 24 个月时，10 只眼中有 7 只完全闭塞了视网膜吻合处。在 24 个月期间，平均 PDT 治疗次数为 2.8 次，平均注射次数为 3.4 次。4 只眼出现地图状萎缩，但 24 个月时 VA 无明显下降。
抗 VEGF 联合 PDT 治疗 RAP 患者可在 24 个月内有效维持或提高 VA，减少渗出，且无严重不良反应。
