Verteporfin治疗年龄相关性黄斑变性黄斑下脉络膜新生血管-开放标志扩展研究的2个随机临床试验的3年结果-TAP报告第5号

目的：报告一项评估Verteporfin光动力疗法对患有黄斑下脉络膜新生血管的年龄相关性黄斑变性患者疗效为期2年的扩展研究得出的视力和安全结果。     

湿性年龄相关性黄斑变性OCT特点与视力的相关研究

目的 研究湿性年龄相关性黄斑变性OCT图像特征与患者视力的相关性.方法 纳入湿性年龄相关性黄斑变性患者106例106只眼,记录患者最佳矫正视力(EDTRS视力),并对患者眼底进行光学相干断层扫描分析,统计黄斑区视网膜厚度、黄斑区总容积、测量脉络膜新生血管膜厚度,脉络膜新生血管与黄斑中心凹距离.结果 患者视力与脉络膜新生血管病变的最大线性距离、黄斑区总容积、CNV厚度、CNV距中心凹距离呈明显相关关系(P＜0.05).结论 湿性年龄相关性黄斑变性患者中心视力与脉络膜新生血管病变的位置、大小、视网膜水肿程度明密切相关.     

年龄相关性萎缩型黄斑变性OCT和电生理检查的关系

目的将年龄相关性萎缩型黄斑变性患者黄斑区的OCT形态学检查及视觉电生理视功能检查相结合,探讨该病变黄斑部形态学改变与视功能改变之间的相互关系。方法选取初次诊断为年龄相关性萎缩型黄斑变性患者35例（40眼）以及同年龄段正常对照20例（40眼）,分别设为萎缩组和正常组。对两组分别进行黄斑中心凹的OCT检查及眼电生理检查,眼电生理检查包括视网膜电图（electroretinogram,ERG）和图形视觉诱发电位（pattern visual evoked potential,P-VEP）。采用独立样本t检验分析检查结果。结果①黄斑中心凹水平及垂直神经上皮层厚度：萎缩组与正常组差异无统计学意义（P〉0.05）。②暗适应ERG：萎缩组较正常组有b波潜伏期的延长（P〈0.05）和a、b波振幅的下降（P〈0.05）;萎缩组a波潜伏期与正常组相比,差异无统计学意义（P〉0.05）。③Ops振荡电位：萎缩组幅值较正常对照组显著下降（P〈0.05）。④P-VEP：萎缩组较正常组（空间频率34′）潜伏期显著延长（P〈0.05）,振幅显著下降（P〈0.05）。结论对于萎缩型黄斑变性患眼,眼电生理的变化早于OCT变化。这说明,年龄相关性萎缩型黄斑变性患者视功能改变早于视网膜神经上皮层的厚度改变,对于早期患者可优先选择电生理检查。     

应用深度增强型成像技术研究早期年龄相关性黄斑变性患者黄斑区脉络膜厚度的变化

目的应用深度增强型相干光断层扫描(EDI-OCT)技术研究早期年龄相关性黄斑变性(AMD)患者黄斑区脉络膜厚度的变化及其与AMD发病的关系。 方法收集2015年3月至2017年3月于中国康复研究中心北京博爱医院眼科就诊的早期AMD患者90例(90只眼)和眼底正常者60例(60只眼)的临床资料。早期AMD患者为患者组,眼底正常者为正常组。患者组中男性51例(51只眼),女性39例(39只眼);年龄63~85岁,平均年龄(74.3±10.9)岁。正常组中男性24例(24只眼),女性36例(36只眼);年龄58~78岁,平均年龄(68.6±10.8)岁。采用EDI-OCT测量两组受试者黄斑中心凹处及由中心凹向鼻侧、颞侧各500 μm、1000 μm处的脉络膜厚度,共测量5个点位。数据以均数±标准差( ±s)表示。两组间脉络膜厚度的比较采用t检验,多组间比较采用单因素方差分析,组间两两比较采用Tukey检验。 结果患者组黄斑区脉络膜的平均厚度为(254.84±51.46)μm;正常组黄斑区脉络膜的平均厚度为(271.46±43.36)μm。患者组黄斑区脉络膜的厚度较正常组低,且两组间差异有统计学意义(t＝-2.061,P<0.05)。所有受试者的年龄与脉络膜的厚度呈负相关,且差异有统计学意义(r＝-0.23,P<0.05)。 结论早期AMD患者的脉络膜厚度较眼底正常者偏薄,且早期AMD患者脉络膜厚度的改变可作为黄斑变性发展的预警因素,能为早期的临床干预提供参考。     

光动力学疗法治疗AMD后OCT检查的特征性改变

目的：通过前瞻性观察PDT治疗湿性年龄相关性黄斑变性（aged-related macular degeneration,AMD）前后不同随访时间点光学相干断层成像（optical coherence tomography, OCT）的特征性改变,旨在更好地反馈PDT治疗后黄斑区结构的变化过程。方法：将在本院接受PDT治疗的26例30眼湿性AMD患者纳入本研究。维速达尔用量根据厂家推荐方法计算。治疗前后均行FFA,ICG,OCT及最佳矫正视力等相关临床检查,术后随访日期为术后2wk; 1,2,3mo。傅立叶OCT扫描以标准五线结合六线扫描,覆盖病变的关键部位并保持前后扫描位置的一致性。重点观察黄斑中心凹层间厚度、外层高反射带高度、囊肿（包括视网膜下积液和视网膜内积液）的总面积。分析这些变化与随访时间的依赖关系。统计分析使用SPSS 13.0软件。结果：至治疗后3mo,PDT治疗后22眼（73%）视力提高两行以上,3眼视力无明显改变,3眼视力下降,2例患者因故失访。视力提高的22眼治疗前平均黄斑厚度为 722.5±55.6μm,治疗后2wk,平均黄斑层间厚度为708.3±45.3μm,1mo 为584.4±49.3μm,2mo为430.7±50.2μm,3mo为 180.6±36.3μm。治疗前和治疗后外层高反射带厚度分别为302.3±50.2,277.5±42.3,202.7±40.1,180.6±35.7,100.8±22.9μm,囊肿的总面积为0.34±0.12,0.25±0.07,0.10±0.05,0.08±0.04,0.05±0.01mm2。结论：AMD患者在PDT治疗后1mo黄斑区视网膜下液有显著吸收,视网膜水肿显著吸收,黄斑中心凹层间厚度、外层高反射厚度也有明显变薄倾向。     

年龄相关性黄斑变性的脉络膜厚度评价

目的：通过光学相干断层扫描(optical coherence tomography, OCT; RTVue 100-2; V 5.1, Optovue, Fremont, CA, USA)测量比较非新生血管性与新生血管性年龄相关性黄斑变性(age-related macular degeneration, AMD)黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness, SFCT), 并分析脉络膜厚度(choroidal thickness, CT)对AMD新血管形成的影响。

方法：本研究为回顾性、横断面研究。以单侧眼患有新生血管性AMD且对侧眼患有非新生血管性AMD的24例患者(48眼)作为研究组,选取年龄与眼轴长度相匹配的40例健康眼作为对照组。非新生血管性AMD亚组研究对象是黄斑区有玻璃疣和/或色素变化眼,而新生血管性AMD亚组研究对象是由于脉络膜新生血管而致视网膜下或视网膜内有渗出液和/或脂性渗出眼。运用OCT垂直测量外侧高反射线(视网膜色素上皮层)到脉络膜巩膜交界面间的距离。选取7个不同点进行脉络膜厚度测量,测量区域为距黄斑中心凹颞侧和鼻侧1 500μm范围,测量间距为500μm。测量结果在亚组间进行统计学对比研究。

结果：研究组患者平均年龄为72.4±8.97(60～82)岁,对照组受试者平均年龄为71.2±8.8(58～81)岁。新生血管性AMD组中平均SFCT明显大于非新生血管性AMD组的厚度(P<0.05)。非新生血管性AMD组中,平均SFCT与平均鼻、颞侧脉络膜厚度比较,差异无统计学意义(P>0.05); 而新生血管性AMD组中,平均SFCT与平均鼻、颞侧脉络膜厚度比较,差异有统计学意义(P<0.05)。

结论：运用OCT对脉络膜厚度进行测量,有助于理解AMD的病理生理机制。然而,仍需要大型前瞻性研究来探求新生血管性AMD中SFCT增厚的原因。     

较大的无血管性PED的预后观察

目的 观察并分析干性年龄相关性黄斑变性(AMD)相关的较大的无血管性视网膜色素上皮脱离(aPED)的变化及转归特点。设计回顾性病例系列。研究对象2013年1月至2023年1月就诊于北京同仁眼科中心,诊断为干性AMD相关的较大的(PED最大水平直径>1500μm,高度>165μm)aPED患者15例(17眼)。方法回顾性分析15例(17眼)较大aPED患者的病历资料,所有患者均经FFA+ICGA+OCT确诊,平均随访时间为(19.76±17.39)个月。观察记录OCT的特点(脉络膜厚度,PED高度、底径宽度,PED塌陷,RPE增殖,视网膜内囊腔,视网膜内高反射灶、视网膜下液,RPE撕裂),地图样萎缩,新生血管形成及最佳矫正视力(BCVA,LogMAR)变化情况。主要指标BCVA,OCT所测量的脉络膜厚度及PED高度、底径宽度。结果基线时平均LogMAR视力为0.55±0.31,黄斑中心脉络膜厚度平均为(237.29±77.39)μm,PED高度平均为(476.67±313.83)p m,PED底径宽度平均为(3268.17±1482.28)μm。末次随访LogMAR视力为0....     

光明亮睛散治疗年龄相关性黄斑变性疗效观察

目的观察光明亮睛散治疗年龄相关性黄斑变性的疗效。方法确诊为年龄相关性黄斑变性患者100例170只眼,分成实验组50例82只眼,对照组50例88只眼。实验组采用光明亮睛散专病专方治疗,对照组采用VitC、VitE、葡萄糖酸锌治疗。观察治疗前后对患者的视力、眼底照相、荧光素眼底血管造影检查情况。结果实验组显效12眼,有效45眼,无效25眼,总有效率69.5%结论应用光明亮睛散治疗年龄相关性黄斑变性有较好的效果,可显著提高视功能     

玻璃体内注射雷珠单抗对重度NPDR黄斑水肿患者脉络膜的影响

目的：探讨玻璃体内注射雷珠单抗治疗重度非增殖性糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)黄斑水肿患者脉络膜的厚度变化情况,分析脉络膜的厚度与患者视力的关系。

方法：选取2014-01-01/2017-01-01于我院接受治疗的80例80眼重度NPDR黄斑水肿患者为研究对象,按照随机数字表法将所有患者分为观察组和对照组,每组40例40眼。对照组采取常规方式治疗,观察组在玻璃体内注射雷珠单抗治疗。记录两组患者治疗前后1mo的黄斑中心凹下脉络膜厚度和黄斑区视网膜神经上皮厚度,并进行比较分析两组患者治疗前后1mo最佳矫正视力的变化情况,通过回归分析研究黄斑中心凹下脉络膜厚度与患者视网膜神经上皮厚度和最佳矫正LogMAR视力值的相关性,比较两组患者治疗后6wk的并发症和不良反应情况。

结果：观察组和对照组治疗前1mo黄斑中心凹下脉络膜厚度和黄斑区视网膜神经上皮厚度分别为219.57±51.24μm和474.76±95.56μm,217.56±50.36μm和473.27±96.48μm; 观察组和对照组治疗后1mo黄斑中心凹下脉络膜厚度和黄斑区视网膜神经上皮厚度分别为180.15±42.06μm和382.18±84.26μm,202.48±48.28μm和407.88±44.25μm,两组患者治疗后比较,差异有统计学意义(P<0.05)。观察组和对照组治疗后1mo最佳矫正LogMAR视力分别为0.47±0.19和0.53±0.25,两组患者治疗后比较,差异有统计学意义(P<0.05),黄斑中心凹下脉络膜厚度和最佳矫正LogMAR视力值存在正相关性(回归系数=1.12,S=0.48,OR=1.376,P<0.05),黄斑区视网膜神经上皮厚度和最佳矫正LogMAR视力值存在正相关性(回归系数=0.95,S=0.27,OR=1.020,P<0.05)。观察组患者治疗后6wk结膜下出血2例2眼(5%)、青光眼1例1眼(2.5%)、玻璃体内积血1例1眼(2.5%)、脉络膜脱离0例、视网膜脱离0例; 对照组患者治疗后6wk结膜下出血4例4眼(10%)、青光眼2例2眼(5%)、玻璃体内积血2例2眼(5%)、脉络膜脱离2例2眼(5%)、视网膜脱离2例2眼(5%); 两组患者并发症和不良反应比较,差异有统计学意义(P<0.05)。

结论：重度NPDR黄斑水肿患者的脉络膜厚度与最佳矫正视力存在相关性,玻璃体内注射雷珠单抗能够有效降低黄斑中心凹下脉络膜厚度,减轻黄斑水肿情况并改善视力,且并发症比较少。     

PDT联合ranibizumab玻璃体腔注射治疗年龄相关性黄斑变性合并CNV

目的：观察 PDT 联合玻璃体腔注射 ranibizumab (雷珠单抗)治疗老年性黄斑变性脉络膜新生血管( choroidal neovascularization,CNV)的疗效。
　　方法：将符合纳入标准,经吲哚青绿脉络膜血管造影(indocyanine green angiography, ICGA)、光学相干断层扫描( optical coherence tomography, OCT)检查确诊为黄斑区脉络膜新生血管( CNV)患者27例27眼,经PDT治疗后3~7 d内行 ranibizumab 玻璃体腔注射。观察治疗后1,3,6 mo、末次随访时行最佳矫正视力、FFA、ICGA、OCT 检查及有无并发症发生情况。
　　结果：最佳矫正视力提高17眼(63%),最佳矫正视力稳定6眼(22%),最佳矫正视力下降4眼(15%)。27例27眼治疗前平均渗漏面积为1005.69±105.47μm,治疗后1,3mo后平均875.54±103.27,423.37±79.68μm,与治疗前比较差异有统计学意义(P<0.01),视网膜黄斑中央厚度27例27眼治疗前平均厚度为485.58±122.59μm,治疗后1,3mo后平均398.84±105.32,297.74±89.18μm,与治疗前比较差异有统计学意义(P<0.01)。
　　结论：PDT 封闭 CNV 后,联合玻璃体内腔内注射ranibizumab,有效阻断新生血管复发,减少PDT再次治疗次数和并发症,可提高治疗效果。     

Macular infarction after transpupillary thermotherapy for subfoveal choroidal neovascularization in age-related macular degeneration

PURPOSE: To report the complication of macular infarction after transpupillary thermotherapy (TTT) for the treatment of subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). DESIGN: Interventional case reports. METHODS: Among 107 consecutive patients with subfoveal CNV due to AMD, a 73-year-old woman with recurrent subfoveal classic choroidal neovascularization and a 76-year-old man with subfoveal occult choroidal neovascularization with adjacent areas of geographic retinal pigment epithelium atrophy noted a severe decrease in visual acuity and photopsias within hours of undergoing TTT. RESULTS: Both patients had marked whitening of the macula clinically and closure of the perifoveal capillaries on fluorescein angiography. Immediately after treatment their visual acuity decreased from 20/200 to 6/200 and from 20/400 to 2/200, respectively. Several months later, all exudation had resolved and their visual acuity had stabilized at 20/100 and 20/200, respectively. CONCLUSIONS: Macular infarction is a rare complication that occurred in two of 107 patients undergoing TTT for subfoveal CNV due to AMD. The presence of geographic retinal pigment epithelium atrophy or a previous laser treatment scar in the macular region may predispose patients to this complication.     

Morphologic and angiographic assessment of the macula after macular translocation surgery with 360 degrees retinotomy

PURPOSE: To compare the optical coherence tomographic assessment of retinal thickness and the fluorescein angiographic appearance after macular translocation surgery for subfoveal choroidal neovascularization. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Twenty-three consecutive eyes. INTERVENTION AND TESTING: Optical coherence tomography and fluorescein angiography were performed before and 6 to 15 months (mean +/- standard error [SE], 10.4+/-0.7) after macular translocation surgery with a 360 degrees retinotomy in 23 patients, ages 48 to 79 years, with age-related macular degeneration (12 eyes), polypoidal choroidal vasculopathy (2 eyes), and high myopia (9 eyes). The diameter of the choroidal neovascularizations ranged from 0.3 to 2.6 disc diameters (mean +/- SE, 1.2+/-0.2), and the angle of rotation of the retina ranged from 11 degrees to 45 degrees (mean +/- SE, 29.1+/-2.1 degrees ). RESULTS: The preoperative best-corrected visual acuity ranged from hand motions to 20/100, and the postoperative best-corrected visual acuity ranged from 20/667 to 20/25. Optical coherence tomography demonstrated a concave foveal configuration after surgery in all 23 eyes, with a mean foveal thickness of 150+/-11 micro m (mean +/- SE). Fluorescein angiography showed various degrees of fluorescein leakage with a pattern similar to cystoid macular edema in 16 of 23 eyes (70%). CONCLUSIONS: The newly located macula after macular translocation surgery with a 360 degrees retinotomy had cystoid macular edema on fluorescein angiography and normal macular configuration with normal thickness in optical coherence tomography.     

经瞳孔温热疗法治疗老年性黄斑变性的疗效观察

目的 观察经瞳孔温热疗法(transpupillary thermotherapy,TTT)治疗渗出型老年性黄斑变性(age—related macular degeneration，AMD)隐匿型脉络膜新生血管(choroidal neovascularization，CNV)的效果。方法 对28例34眼经眼底荧光血管造影(fundus fluorescein angiography，FFA)及吲哚青绿血管造影(indocyanine green angiography，ICGA)确诊的继发于渗出型AMD的隐匿型CNV行TTT治疗，并主要以视力、眼底检查、FFA及ICGA改变为指标，评价TTT治疗渗出型AMD的效果。结果 随访3～20个月，平均6.65个月，视力提高19眼，视力稳定13眼，视力下降2眼，视网膜水肿基本消退6眼，水肿明显减轻21眼，水肿无明显变化5眼，2眼水肿加重，出血吸收22眼，8眼出血减少，出血无明显变化者2例，另有2眼发生少量新鲜视网膜深层出血，第1次治疗后复查FFA及ICGA，10眼CNV消失，19眼CNV渗漏减轻，3眼无明显变化，2眼CNV增大。结论 TTT治疗可使大部分AMD患者视力稳定或提高，是一种极具潜力的治疗方式，但对其确切疗效的评价。尚需与自然病程及其他治疗方法对比。     

Surgical excision versus laser photocoagulation for subfoveal choroidal neovascular membrane with age-related macular degeneration: comparison of visual outcomes

PURPOSE: This study was designed to compare visual acuity after laser photocoagulation with visual acuity after surgical excision of the subfoveal choroidal neovascular membrane in patients with age-related macular degeneration (AMD). METHODS: We studied 54 patients (56 eyes) who underwent laser photocoagulation and 52 patients (52 eyes) who underwent surgical excision for new subfoveal choroidal neovascular membrane occurring with AMD. We compared mean log of minimal angle of resolution (MAR) visual acuity, and the percentages of eyes showing visual improvement and a visual acuity of 0.1 or better, between the two treatment groups at 12 months after treatment. The groups were also compared according to choroidal neovascular membrane size, ie, 1 disc diameter (DD) or smaller vs larger than 1 DD. RESULTS: Mean corrected visual acuity (P <.01), percentage of eyes with improved vision (P <.01), and percentage with a visual acuity of at least 0.1 (P <.01) were higher in surgically treated eyes. The differences in mean log MAR visual acuity and the percentages were significant only for choroidal neovascular membrane of one DD or less in size. CONCLUSIONS: Postoperative eyes, especially those with choroidal neovascular membranes 1 DD or less in size, had better visual outcomes. Patients who meet our eligibility criteria, especially with small choroidal neovascular membranes 1 DD or less in size, should undergo surgical excision.     

Assessment of foveal function in eyes of patients with exudative age-related macular degeneration before and after argon laser treatment

PURPOSE: 1. Can foveal cone electroretinogram (FCERG) be a useful diagnostic test in evaluation of efficacy of argon laser treatment in eyes with exudative (wet) age-related macular degeneration (AMD)? 2. Comparison of FCERG with visual acuity, static perimetry and fluorescein angiography results. MATERIAL AND METHODS: FCERGs were recorded from 30 eyes with mean visual acuity 0.6 (Snellen Table) of 20 patients (mean age: 61 years) with wet AMD. The fovea was stimulated with 5-degree flickering light spot (f = 31.25 Hz), surrounded by a 20-degree annulus of intensive steady retinali illuminance. FCERGs were recorded and analysed in amplitude according to the computer-aided method recently put in practice in our laboratory. FCERGs were obtained twice for each AMD patients: before and 3 months after argon laser treatment. Electrophysiological data were also compared with the results of fluorescein angiography, visual acuity and static perimetry. RESULTS: In the group of patients with wet AMD, significant increase of FCERG amplitude (p < 0.001) after laser treatment was obtained in group I (33% of analysed eyes) and there were mainly patients with extrafoveal choroidal neovascularisation (CNV). Significant decrease of FCERG amplitude (p < 0.01) was obtained in group II (67% of analysed eyes). These were mainly patients with subfoveal CNV and also with extrafoveal CNV. In both groups after laser treatment we did not receive significant changes in visual acuity and macular perimetric mean sensitivity. CONCLUSIONS: These findings suggest that foveal cone ERG can be a useful, independent from fluorescein angiography, test for objective evaluation of efficacy of argon laser treatment in patients with wet AMD, opposite to visual acuity and static perimetry (macula threshold) examinations. FCERG probably indicates patients with better or worse prognosis.     

经瞳孔温热疗法治疗老年黄斑变性所致黄斑中心凹下脉络膜新生血管的长期观察(英文)

目的:评价经瞳孔温热疗法(TTT)治疗年龄相关性黄斑变性(AMD)所致黄斑中心凹下脉络膜新生血管(CNV)的长期疗效。方法:AMD所致黄斑中心凹下脉络膜新生血管14例14眼。平均年龄67.1岁。记录详尽的眼科检查结果,拍摄彩色眼底相,并行黄斑部光学相干断层成像(OCT)检查。在初诊及随后的复诊中行眼底荧光素血管造影和吲哚青绿血管造影。TTT的治疗参数为:时间1min,光斑大小2 ~3mm,激光能量650 ~800mW。随诊时间5 ~64mo,平均28.6mo。结果:在14眼中,典型性CNV有10眼,典型为主性有2眼,1眼为少量典型性,1型隐匿性CNV有1眼。共4例患者出现治疗后出血,均在短期内吸收。有1眼在治疗后立刻出现了黄斑无灌注区。多数患眼在随诊中可见渗出逐渐减少。在平均28.6mo的随诊中,14只患眼,有5眼视力提高,8眼保持稳定,1眼视力下降。结论:经瞳孔温热疗法在AMD患者中能封闭黄斑中心凹下的CNV,促进网膜下积液的迅速吸收,从而稳定患者的视力。它可以作为一种治疗典型和典型为主性黄斑中心凹下脉络膜新生血管的激光治疗手段。     

Long-term efficacy of transpupillary thermotherapy for subfoveal choroidal neovascularization in age-related macular degeneration

AIM: To determine the long-term efficacy of transpupillary thermotherapy (TTT) in the treatment of subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD). METHODS: Fourteen eyes of 14 patients with subfoveal CNV secondary to AMD were treated with diode laser (810nm) TTT. The mean age was 67.1 years. Complete ophthalmic examination was done, color fundus photographs and macular optical coherence tomography scans were taken, fluorescein and indocyanine green angiography were performed during initial and at subsequent follow-up examinations. Treatment was given in one minute using 2-3mm spot sizes, and laser power settings were between 650-800mW. The follow-up period was between 5 and 64 months and the mean was 28.6 months. RESULTS: There was subfoveal classic CNV in 10, predominantly classic CNV in 2, minimally classic CNV in 1, and type 1 occult CNV in one of the fourteen eyes. Four patients were noted to have post-treatment hemorrhage which was absorbed in a short time. Macular non-perfusion occurred in one patient immediately after treatment. Most of the eyes demonstrated a decrease in exudation during the follow-up. With a mean follow-up of 28.6 months, visual acuity improved in 5, remained the same in 8 and decreased in 1 of the 14 eyes. CONCLUSION: Transpupillary thermotherapy is shown to close subfoveal CNV with rapid resolution of subretinal fluid while maintaining visual function in patients with AMD. It may be performed as an alternative laser treatment in classic and predominantly classic subfoveal choroidal neovascularization due to AMD.     

Verteporfin Therapy for Neovascular Age-Related Macular Degeneration in Indian Eyes

Purpose To determine visual outcome after a 12-month follow-up period of verteporfin therapy for subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) in Indian patients. Methods Twenty-five patients (26 eyes) who completed a 12-month follow-up after photodynamic therapy for subfoveal CNV secondary to AMD were included in the study. The follow-up schedule was every month for 2 months and then every 3 months thereafter until 12 months. Improvement in visual acuity was defined as a ≥10-letter gain, and deterioration as a ≥10-letter loss in the Early Treatment Diabetic Retinopathy Study chart at 4 m. Results The mean age of the 25 patients was 62.3 ± 9 years. There were 17 male patients (68%). The mean initial letter acuity was 28. 4 ± 14.1, and the final letter acuity was 25.5 ± 18.4 at 12 months. Initial visual acuity was ≥20/40 in seven eyes, 20/50–20/80 in nine eyes, and 20/100–20/200 in ten eyes; seven eyes had a ≥10-letter gain, and three eyes had a ≥10-letter loss. At the end of 12 months, six eyes had a ≥10-letter gain and ten eyes had a ≥10-letter loss. Conclusion Photodynamic therapy appears to preserve the vision in subfoveal CNV secondary to AMD in the eyes of Indian patients.     

光动力疗法治疗老年黄斑变性临床初步观察

目的　观察应用光动力疗法 (photodynam ic therapy,PDT )单次治疗渗出型年龄相关性黄斑变性 (age- related m acu-lar degeneration,A MD )并发脉络膜新生血管 (choroidal neovascularization,CN V )的近期治疗效果。方法　以眼底检查、视力、眼底荧光血管造影 (FFA)、吲哚青绿脉络膜血管造影 (ICG)和光学相干断层成像技术 (O CT)等影像学检查为观察指标 ,总结PDT治疗 15例 16眼 A MD合并的典型 CNV后 1周和 1个月随访的短期治疗效果 ,从而评价 PDT治疗 CNV的安全性和短期治疗效果。结果　治疗后 1周和 1个月分别有 6眼和 10眼视力不同程度提高 ,1眼因新出血视力略有下降 ,无证据表明与治疗有关。 15例 16眼治疗后荧光渗漏均有不同程度的减弱或消退 ,其中 7例 8眼渗漏完全消退 ,1月后复查无复发 ;其余 8例8眼荧光渗漏明显减轻。全部 15例治疗过程中未发生任何不良反应 ;仅 3例治疗后主述有一过性轻度视力紊乱。结论　光动力疗法单次治疗渗出型年龄相关性黄斑部变性并发的脉络膜新生血管膜短期疗效满意、安全 ,对视力无损害。