Tanaka Koji, Onoe Hajime, Takeshima Keigo, Kono Michiteru, Wakatsuki Yu, Kawamura Akiyuki, Mori Ryusaburo, Nakashizuka Hiroyuki
Department of Ophthalmology, Nihon University School of Medicine, Nihon University Hospital, Tokyo, Japan.
Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, 1-6 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8309, Japan.
Sci Rep. 2025 May 30;15(1):18975. doi: 10.1038/s41598-025-03782-2.
The purpose of this study was to determine the recurrence rate, factors, incidence of polypoidal lesions, and risk factors for developing polypoidal lesions after a reduced dose photodynamic therapy (PDT) for pachychoroid neovasculopathy (PNV) without polypoidal lesions. This study is an observational case-control study. The study included 105 patients (77 men, 28 women; mean age, 61.6 years) with PNV in 105 eyes treated with reduced PDT. Twenty-eight eyes were treated with half-dose PDT and 77 eyes with two-thirds dose PDT, with an average follow-up of 588 days. Logistic regression analysis was used to examine factors of recurrence and polypoidal lesions. Recurrence was observed in six patients (21%) receiving half-dose PDT and 24 patients (31%) receiving two-thirds dose PDT. Polypoidal lesions developed in seven patients (7%). Recurrence factors were duration of follow-up (P < 0.0001), macular neovascularization (MNV) thickness before PDT (P = 0.010), and age (P = 0.002). MNV area before PDT was an independent risk factor for the development of polypoidal lesions (P = 0.001). Long-term follow-up after reduced PDT for PNV is necessary because recurrence factors include follow-up duration, age, and MNV thickness. A risk factor for polypoidal lesions after PNV treatment was the MNV area before PDT.
本研究的目的是确定在对无息肉样病变的厚脉络膜新生血管病变（PNV）进行减量光动力疗法（PDT）后，其复发率、相关因素、息肉样病变的发生率以及发生息肉样病变的危险因素。本研究是一项观察性病例对照研究。该研究纳入了105例接受减量PDT治疗的PNV患者（77例男性，28例女性；平均年龄61.6岁），共105只眼。28只眼接受半量PDT治疗，77只眼接受三分之二量PDT治疗，平均随访588天。采用逻辑回归分析来研究复发和息肉样病变的相关因素。接受半量PDT治疗的6例患者（21%）和接受三分之二量PDT治疗的24例患者（31%）出现复发。7例患者（7%）出现息肉样病变。复发因素包括随访时间（P＜0.0001）、PDT前黄斑新生血管（MNV）厚度（P = 0.010）和年龄（P = 0.002）。PDT前MNV面积是发生息肉样病变的独立危险因素（P = 0.001）。对PNV进行减量PDT后进行长期随访是必要的，因为复发因素包括随访时间、年龄和MNV厚度。PNV治疗后息肉样病变的一个危险因素是PDT前MNV面积。
