Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan; Department of Ophthalmology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Am J Ophthalmol. 2013 Sep;156(3):548-556. doi: 10.1016/j.ajo.2013.03.041. Epub 2013 Jun 28.
To evaluate subfoveal choroidal thickness changes in cases with recurrent polypoidal choroidal vasculopathy (PCV) after combination therapy with intravitreal ranibizumab and photodynamic therapy (PDT).
Retrospective observational case series study.
We measured subfoveal choroidal thickness in PCV using optical coherence tomography (OCT) before and after PDT. In recurrent cases, the choroidal thickness was measured at the time of the recurrence. In nonrecurrent cases, choroidal thickness was measured 1 year after PDT.
Combination therapy was performed in 27 eyes (27 patients). Polypoidal lesions regressed within 3 months after initial treatment in all eyes. Retreatment was needed in 10 of 27 eyes (37.0%) after more than 3 months of follow-up. In recurrent cases, subfoveal choroid decreased from 188 μm at baseline to 157 μm 3 months after PDT (P < .01); however, choroidal thickness increased to 179 μm with recurrence (P = .54 compared to baseline; average, 8.0 months). In nonrecurrent cases, subfoveal choroid decreased from 257 μm at baseline to 210 μm 3 months after PDT and 212 μm 1 year after PDT (P < .01, respectively).
Subfoveal choroidal thickness in PCV at the time of recurrence returned to the baseline level after choroidal thinning as a result of PDT treatment. Choroidal thickness changes after PDT examined using OCT may reflect disease activity in PCV.
评估玻璃体内雷珠单抗联合光动力疗法（PDT）治疗后复发性息肉状脉络膜血管病变（PCV）患者的黄斑下脉络膜厚度变化。
回顾性观察性病例系列研究。
我们使用光学相干断层扫描（OCT）测量 PDT 前后 PCV 的黄斑下脉络膜厚度。在复发性病例中，在病变复发时测量脉络膜厚度。在非复发性病例中，在 PDT 后 1 年测量脉络膜厚度。
27 只眼（27 例）接受了联合治疗。所有眼的息肉样病变在初始治疗后 3 个月内消退。在超过 3 个月的随访后，27 只眼中有 10 只眼（37.0%）需要再次治疗。在复发性病例中，黄斑下脉络膜从 PDT 前的 188μm 减少到 PDT 后 3 个月的 157μm（P<.01）；然而，随着病变复发，脉络膜厚度增加到 179μm（与基线相比，P=.54；平均时间为 8.0 个月）。在非复发性病例中，黄斑下脉络膜从基线的 257μm 减少到 PDT 后 3 个月的 210μm 和 PDT 后 1 年的 212μm（P<.01，分别）。
PDT 治疗导致脉络膜变薄后，复发性 PCV 黄斑下脉络膜厚度恢复到基线水平。OCT 检查的 PDT 后脉络膜厚度变化可能反映 PCV 的疾病活动。
