Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Jpn J Ophthalmol. 2013 May;57(3):301-7. doi: 10.1007/s10384-013-0237-9. Epub 2013 Mar 19.
To evaluate the long-term effects of photodynamic therapy (PDT) on typical neovascular age-related macular degeneration (tAMD) and polypoidal choroidal vasculopathy (PCV).
This was a multicenter prospective study of 139 eyes from 136 patients (tAMD: 74 eyes; PCV: 65 eyes) who underwent PDT as the initial treatment. The change in best-corrected visual acuity (BCVA), predictive factors for the BCVA at 60 months, frequency of recurrence, and mean recurrence period were analyzed.
The pre-PDT BCVA and greatest linear dimension (GLD) did not differ between the two groups. The mean BCVA (logMAR) was significantly improved at 6 months post-initial PDT (post-PDT) in the PCV group (-0.11, P = 0.0091). However, at 60 months post-PDT, the mean BCVA was significantly worse than baseline in the tAMD (+0.21, P = 0.0035) and PCV (+0.21, P = 0.0076) groups. Pre-PDT BCVA, age, and GLD were the factors significantly associated with the BCVA at 60 months post-PDT. Although the frequency of recurrence did not significantly differ between the two phenotype groups, the mean recurrence period was significantly longer in the PCV group than in the tAMD group (15.7 vs. 8.6 months, P = 0.0020).
PDT may not have benefits for visual acuity in cases of tAMD and PCV over 5 years of follow-up.
评估光动力疗法（PDT）对典型新生血管性年龄相关性黄斑变性（tAMD）和息肉样脉络膜血管病变（PCV）的长期疗效。
这是一项多中心前瞻性研究，纳入了 136 名患者的 139 只眼（tAMD：74 只眼；PCV：65 只眼），这些患者接受 PDT 作为初始治疗。分析最佳矫正视力（BCVA）的变化、60 个月时 BCVA 的预测因素、复发频率和平均复发间隔。
两组患者的 PDT 前 BCVA 和最大线性尺寸（GLD）无差异。PCV 组在初始 PDT 后 6 个月（PDT 后）的平均 BCVA（logMAR）显著提高（-0.11，P = 0.0091）。然而，在 PDT 后 60 个月时，tAMD（+0.21，P = 0.0035）和 PCV（+0.21，P = 0.0076）两组的平均 BCVA 均显著低于基线。PDT 前 BCVA、年龄和 GLD 是与 PDT 后 60 个月时 BCVA 相关的因素。尽管两组患者的复发频率无显著差异，但 PCV 组的平均复发间隔明显长于 tAMD 组（15.7 比 8.6 个月，P = 0.0020）。
在 5 年以上的随访中，PDT 可能对 tAMD 和 PCV 的视力获益无影响。
