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高加索人息肉状脉络膜血管病变患者的临床结果。

Clinical outcomes in Caucasian patients with polypoidal choroidal vasculopathy.

机构信息

St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.

出版信息

Eye (Lond). 2018 Nov;32(11):1731-1739. doi: 10.1038/s41433-018-0168-2. Epub 2018 Jul 12.

Abstract

PURPOSE

To describe treatment outcomes in a cohort of Caucasian patients with polypoidal choroidal vasculopathy (PCV).

METHODS

Clinical charts from 48 eyes of 45 Caucasian patients with PCV were retrospectively reviewed. All cases were diagnosed with indocyanine green angiography. Best corrected visual acuity (BCVA) and optical coherence tomography (OCT) imaging were analyzed at baseline and final follow-up.

RESULTS

Eyes were treated with a combination of verteporfin photodynamic therapy (PDT) and anti-vascular endothelial growth factor (VEGF) (n = 24), or PDT monotherapy (n = 9), or anti-VEGF monotherapy (n = 8), or no treatment (n = 7). Aflibercept was the anti-VEGF agent in 30 out of 32 eyes. Sixteen out of 24 eyes in the combination treatment group received initial PDT at diagnosis. All treatments led to stabilization of BCVA at final visit with a trend for better visual acuity in the anti-VEGF monotherapy group. There was a substantial reduction in central retinal thickness associated with resolution of subfoveal fluid and improvement in retinal pigment epithelial detachment in all treatment groups. BCVA and OCT findings remained stable in eyes which received no treatment. The use of PDT was associated with 0.5 fewer intravitreal injections per annum, which was not statistically significant.

CONCLUSIONS

In the largest series of Caucasian patients with PCV presented to date, anti-VEGF monotherapy, PDT, or their combination preserved visual acuity and improved subfoveal exudative changes. Combination treatment was not superior to anti-VEGF monotherapy.

摘要

目的

描述一组白种人息肉状脉络膜血管病变(PCV)患者的治疗结果。

方法

回顾性分析了 45 名白种人 PCV 患者的 48 只眼的临床图表。所有病例均通过吲哚菁绿血管造影(ICG)诊断。在基线和最终随访时分析最佳矫正视力(BCVA)和光学相干断层扫描(OCT)图像。

结果

眼采用联合维替泊芬光动力疗法(PDT)和抗血管内皮生长因子(VEGF)(n=24)、PDT 单药治疗(n=9)、抗 VEGF 单药治疗(n=8)或未治疗(n=7)治疗。32 只眼中的 30 只使用了阿柏西普作为抗 VEGF 药物。24 只联合治疗组中有 16 只眼在诊断时接受初始 PDT。所有治疗方法在最终随访时均使 BCVA 稳定,抗 VEGF 单药治疗组的视力有改善趋势。所有治疗组均伴有中心视网膜厚度显著降低,伴或不伴黄斑中心凹下积液消退和视网膜色素上皮脱离改善。未治疗的眼的 BCVA 和 OCT 发现保持稳定。PDT 的使用与每年减少 0.5 次玻璃体内注射相关,但无统计学意义。

结论

在迄今报道的最大一组白种人 PCV 患者中,抗 VEGF 单药治疗、PDT 或两者联合治疗可保留视力并改善黄斑下渗出性病变。联合治疗并不优于抗 VEGF 单药治疗。

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