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用干扰素-α-2a治疗年龄相关性黄斑变性

[Treatment of age-associated macular degeneration with interferon-alfa-2a].

作者信息

Thölen A, Kain H, Messmer E

机构信息

Universitäts-Augenklinik Zürich.

出版信息

Ophthalmologe. 1993 Jun;90(3):279-82.

PMID:8334332
Abstract

Laser treatment of subfoveal neovascular membranes secondary to age-related macular degeneration (AMD) has been proven to be beneficial with regard to long-term contrast sensitivity and central scotoma size, but significant visual loss occurs immediately after treatment and it is therefore not generally accepted. Alternative treatment modalities should be evaluated. The observation made by Dr. W. Fung that patients with subretinal neovascular membranes may benefit from systemic treatment with the angiogenesis inhibitor interferon alpha-2a has stimulated much interest in this new treatment modality. We present four patients suffering from a subfoveal neovascular membrane who have been treated with this drug. In three cases the membrane was of an occult type, in one case there was a combination of classic and occult choroidal neovascularization. In all patients there had been progressive visual loss during the last 6 months prior to treatment. Visual acuity stabilized in three cases with occult neovascularization. In one case with classic choroidal neovascularization the membrane increased in size during treatment and a further drop of visual acuity was noted. Despite the fact that serious side effects could not be observed in our patients, the results do not allow to recommend Interferon for widespread use in the treatment of subretinal neovascular membranes, especially because the number of patients was small and the follow up time short. Its efficacy needs to be demonstrated by randomized clinical trials.

摘要

激光治疗年龄相关性黄斑变性(AMD)继发的黄斑下新生血管膜,已被证明在长期对比敏感度和中心暗点大小方面是有益的,但治疗后会立即出现明显的视力丧失,因此尚未被广泛接受。应评估其他治疗方式。W. Fung医生观察到视网膜下新生血管膜患者可能从血管生成抑制剂α-2a干扰素的全身治疗中获益,这激发了人们对这种新治疗方式的极大兴趣。我们报告了4例接受该药治疗的黄斑下新生血管膜患者。3例患者的新生血管膜为隐匿型,1例患者同时存在典型和隐匿性脉络膜新生血管。所有患者在治疗前的最后6个月中视力均逐渐下降。3例隐匿性新生血管患者的视力稳定。1例典型脉络膜新生血管患者在治疗期间新生血管膜增大,视力进一步下降。尽管在我们的患者中未观察到严重的副作用,但由于患者数量少且随访时间短,这些结果并不足以推荐干扰素广泛用于治疗视网膜下新生血管膜。其疗效需要通过随机临床试验来证实。

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