病理性近视脉络膜新生血管形态学分析及单次光动力治疗临床效果观察

目的分析病理性近视脉络膜新生血管(choroidal neovascularization,CNV)图像特征,并观察单次光动力治疗(photo-dynamic therapy,PDT)治疗CNV的临床效果。方法确诊病理性近视CNV患者12例13眼,进行单次PDT治疗,随访1～24个月,平均7.7个月,观察PDT前后症状、视力以及CNV的光学相干断层扫描(optical coherence tomography,OCT)、荧光素眼底血管造影(fundus fluorescein angiography,FFA)、吲哚菁绿脉络膜血管造影(indocyanine green angiography,ICGA)、眼底照像的变化,探讨CNV的形态学特征及PDT治疗效果。结果 60.0%眼视物变形症状减轻或消失。末次随访时84.6%眼保持PDT前裸眼视力或不同程度提高。OCT将CNV分为类圆形、纺锤形、不规则形及色素上皮下型;结果示8眼类圆形CNV经过PDT治疗后6眼(占总数的46.2%)CNV瘢痕形成、2眼(占总数的15.4%)无改善,其他型CNV5眼(占总数的38.5%,包括纺锤形、不规则形及色素上皮下型)经过PDT后CNV消退。眼底血管造影示92.3%眼荧光素渗漏减弱或消退,7.7%眼荧光素渗漏未见减弱。眼底照像可见69.2%眼有Fuch斑;30.8%眼有灰色、扁平、较小病灶,相应处CNV形成;30.8%可见黄斑新鲜出血。结论 OCT对病理性近视CNV形态分型、观察具有重要意义;单次PDT具有抑制或消退CNV的作用和稳定视力的临床效果。

Features of choroidal neovascularization secondary to pathological myopia and clinical outcome treated by one time photodynamic therapy

Objective To explore morphological features of choroidal neovascularisation(CNV) and to evaluate clinical effects of CNV treated by one time photodynamic therapy(PDT) in pathological myopia.Methods About 12 CNV patients(13 eyes) with pathological myopia were treated by PDT.All patients were followed up for 1 month to 24 months after PDT therapy,averaged in 7.7 months.Symptoms,visual acuity,and CNV were evaluated by optical coherence tomography(OCT),fundus fluorescein angiography(FFA) and indocyanine green a...