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阿柏西普联合80%剂量光动力疗法治疗厚脉络膜新生血管病变的疗效

Efficacy of aflibercept combined with 80% dose photodynamic therapy for pachychoroid neovasculopathy.

作者信息

Nakagawa Norihiko, Maruyama Kohei, Nishiyama Issei, Sawa Miki

机构信息

Eye Center, Sakai City Medical Center, Osaka, Japan.

出版信息

Sci Rep. 2025 Jul 2;15(1):23556. doi: 10.1038/s41598-025-07018-1.

DOI:10.1038/s41598-025-07018-1
PMID:40604105
Abstract

To evaluate the short-term treatment outcomes of 80% dose photodynamic therapy (PDT) combined with intravitreal aflibercept injection (IVA) for symptomatic pachychoroid neovasculopathy (PNV) in a working-age population. We retrospectively reviewed a total of 137 eyes of 128 patients (108 males and 20 females) with PNV who were treated with combination therapy. All patients were working-age individuals, and the mean age was 49.0 ± 7.3 (range 33-65) years. Reduced-PDT (80% dose) was performed within 1 week of IVA. The presence of subretinal fluid  (SRF) at 1 month and changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), subfoveal choroidal thickness (SFCT), and fundus autofluorescence findings were assessed between at baseline and 1 month. One month after the combination therapy, SRF was resolved in 128 eyes (93.4%). The median (interquartile range) BCVA was 0.0 (- 0.08, 0.10)/- 0.08 (- 0.18, 0.05) (p < 0.001), the mean CRT was 374 ± 112/221 ± 36 (p < 0.001), and the mean SFCT was 416 ± 89/371 ± 92 (p < 0.001) at baseline and 1 month, respectively. Hypoautofluorescence, indicating macular atrophy was observed in 1 eye, and 1 eye developed transient visual loss at posttreatment. In terms of the rapid resolution of SRF and the improvement in VA, reduced-PDT combined with IVA can be a treatment option for PNV in the working-age population.

摘要

评估80%剂量光动力疗法(PDT)联合玻璃体内注射阿柏西普(IVA)治疗工作年龄人群症状性厚脉络膜新生血管病变(PNV)的短期治疗效果。我们回顾性分析了128例(108例男性和20例女性)接受联合治疗的PNV患者的137只眼。所有患者均为工作年龄个体,平均年龄为49.0±7.3(范围33 - 65)岁。在IVA后1周内进行减量PDT(80%剂量)。在基线和1个月时评估1个月时视网膜下液(SRF)的存在情况以及最佳矫正视力(BCVA)、中心视网膜厚度(CRT)、黄斑下脉络膜厚度(SFCT)和眼底自发荧光检查结果的变化。联合治疗1个月后,128只眼(93.4%)的SRF消退。基线和1个月时,BCVA的中位数(四分位间距)分别为0.0(-0.08,0.10)/-0.08(-0.18,0.05)(p<0.001),平均CRT分别为374±112/221±36(p<0.001),平均SFCT分别为416±89/371±92(p<0.001)。1只眼观察到提示黄斑萎缩的低自发荧光,1只眼在治疗后出现短暂视力丧失。就SRF的快速消退和视力改善而言,减量PDT联合IVA可作为工作年龄人群PNV的一种治疗选择。

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本文引用的文献

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Three-year outcome of photodynamic therapy combined with VEGF inhibitor for pachychoroid neovasculopathy.光动力疗法联合血管内皮生长因子抑制剂治疗厚脉络膜新生血管病变的 3 年疗效。
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Eye (Lond). 2023 Apr;37(6):1067-1072. doi: 10.1038/s41433-022-02067-6. Epub 2022 Apr 14.
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Dose-Related Structural Effects of Photodynamic Therapy on Rabbit Choroidal Structure.光动力疗法对兔脉络膜结构的剂量相关结构影响。
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Long-term outcome of intravitreal anti-vascular endothelial growth factor treatment for pachychoroid neovasculopathy.脉络膜增厚型新生血管病变的玻璃体内抗血管内皮生长因子治疗的长期疗效。
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Two-Thirds Dose Photodynamic Therapy for Pachychoroid Neovasculopathy.三分之二剂量光动力疗法治疗厚脉络膜新生血管病变
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Effects of Intravitreous Aflibercept Injection in Pachychoroid Neovasculopathy: Comparison with Typical Neovascular Age-Related Macular Degeneration.玻璃体内注射阿柏西普治疗厚脉络膜新生血管病的效果:与典型年龄相关性黄斑变性新生血管的比较。
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Photodynamic therapy combined with anti-vascular endothelial growth factor therapy for pachychoroid neovasculopathy.光动力疗法联合抗血管内皮生长因子治疗厚脉络膜新生血管病。
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