中心性渗出性脉络膜视网膜病变的吲哚青绿造影特征

目的:分析中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy,CEC)吲哚青绿血管造影(indocyaninegreen angiography,ICGA)特点。方法:应用海德堡造影系统HRA2对24例24眼CEC患者进行荧光素、吲哚青绿眼底血管造影,并对ICGA与眼底荧光造影(fundus fluorescein angiography,FFA)结果进行对比分析。结果:CEC患者24眼FFA均证实为典型性脉络膜新生血管(choroidal neovascularization,CNV)。ICGA早期,24例CEC可见边界清晰的网状CNV。5例见CNV周围局限性脉络膜血管扩张。ICGA晚期可见CNV处染料渗漏或染色。20眼ICGA早期可见宽窄不一的暗环包绕CNV,4眼未见暗环。ICGA晚期,24眼CNV周围均可见暗环。1例患者光动力(photodynamic therapy,PDT)治疗后2mo,因视力继续下降复查ICGA,可见视网膜脉络膜血管吻合(retinal-choroidal anastomosis,RCA)。结论:由HRA2进行的ICGA对CEC的CNV的结构、边界、局部脉络膜静脉的改变、RCA的显示优于FFA。     

中心性渗出性脉络膜视网膜病变的光学相干断层扫描图像特征

目的
观察中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy，CEC)脉络膜新生血管（choroidal neovascularization，CNV）的光学相干断层扫描（optical coherence tomography，OCT）图像特征。
方法
对41例发病时间从1周～10个月的CEC患者的 43只患眼进行荧光素眼底血管造影（fundus fluorescein angiography，FFA）和OCT检查，其中27只患眼在 FFA检查的同时进行了吲哚青绿眼底血管造影（indocyanine green angiography，ICGA）检查。对比分析其CNV的OCT和 FFA及ICGA图像特征。
结果
CEC的OCT图像表现为边界清楚的CNV（41.86%）、边界不清的 CNV（30.23%）、出血性色素上皮脱离（pigment epithelium detachment，PED）（16.28%）、伴有浆液性（6.98%）或出血性神经上皮脱离的CNV（4.65%） 5种形态。其中以边界清楚的CNV和边界不清的CNV为主，共占72.09 %。视网膜血管造影，能清楚确定CNV的边界者，FFA、ICGA检查分别为12、20只眼；OCT从视网膜断层切面上能清楚确定CNV边界者23只眼。FFA检查上典型的CNV，OCT图像通常也表现为边界清楚的CNV；FFA检查上非典型的CNV，OCT图像表现为多种形态。
结论
CEC的OCT图像特征以边界清楚的CNV和边界不清的CNV为主。OCT检查可以从视网膜断面上准确观察CEC病灶视网膜及脉络膜毛细血管层的形态，对FFA、ICGA从视网膜脉络膜平面上对CNV的观察有很好地补充作用。
(中华眼底病杂志, 2002, 18: 121-124)     

渗出型老年性黄斑变性和中心性渗出性脉 络膜视网膜病变脉络膜新生血管的 光学相干断层扫描

目的观察渗出型老年性黄斑变性(exudative age-related macular degeneration, AMD)和中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy, CEC)脉络膜新生血管 (choroidal neovascularization, CNV) 的光学相干断层扫描 (optical coherence tomography, OCT) 图像特征并比较两者之间的差异。方法对渗出型AMD 患者22例23只眼,CEC患者19例20只眼进行OCT检测,应用OCT软件进行CNV大小及黄斑中心凹视网膜神经上皮层厚度测量并分析两者与视力的关系。结果CNV的OCT 图像主要表现有：单纯性CNV、CNV伴浆液性神经上皮层脱离和CNV伴脉络膜视网膜渗出(可伴有浆液性神经上皮层脱离及浆液性或出血性色素上皮脱离)。渗出型AMD的CNV以CNV伴脉络膜视网膜渗出为主,有13只眼,占56.52%,其CNV累及范围较大;CEC的CNV以单纯性CNV为主,有18只眼,占90.00 %,其CNV累及范围相对较小。两组患者视力与黄斑中心凹视网膜神经上皮层厚度呈负相关( γ=-0.521,P=0.001)。结论渗出型AMD与CEC其CNV具有不同的OCT 形态特征,CNV累及范围也有差异。(中华眼底病杂志,2001,17:299-302)     

光动力疗法治疗中心性渗出性脉络膜视网膜病变疗效观察

目的 评价光动力疗法(photodynamictherapy,PDT)治疗中心性渗出性脉络膜视网膜病变(centralexudativehorioretinopathy,CEC)的临床疗效.方法 对比分析中心性渗出性脉络膜视网膜病变所致黄斑部脉络膜新生血管(choroidaineovascularization,CNV)患眼21例,治疗前与单次PDT治疗后3个月的视力、眼底、固视性质、光学相干断层扫描(optic coherence tomograph,OCT)图像及荧光素钠血管造影(fundus fluoresein angiography,FFA)、吲哚菁绿血管造影(indocyanine greenan giography,ICGA)的变化.结果 PDT治疗后3个月11只眼视力提高(52.38%),10只眼视力稳定(47.62%),其中5例由偏心固视恢复为中心固视.眼底检查可见出血渗出明显减少,部分患者完全吸收.FFA联合ICGA检查显示CNV病灶渗漏停止10只眼(47.62%),渗漏减少10只眼(47.62%);OCT检查表现为CNV缩小.组织水肿减轻.结论 PDT治疗可以部分或完全封闭中心性渗出性脉络膜视网膜病变所致的CNV,减少CNV引起的视力下降的危险性.     

眼底血管造影联合频域光相干断层扫描同步检查法对渗出性老年性黄斑变性脉络膜新生血管的诊断价值

Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.     

眼底血管造影联合频域光相干断层扫描同步检查法对渗出性老年性黄斑变性脉络膜新生血管的诊断价值

Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.     

眼底血管造影联合频域光相干断层扫描同步检查法对渗出性老年性黄斑变性脉络膜新生血管的诊断价值

Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.     

眼底血管造影联合频域光相干断层扫描同步检查法对渗出性老年性黄斑变性脉络膜新生血管的诊断价值

Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.     

眼底血管造影联合频域光相干断层扫描同步检查法对渗出性老年性黄斑变性脉络膜新生血管的诊断价值

Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.     

眼底血管造影联合频域光相干断层扫描同步检查法对渗出性老年性黄斑变性脉络膜新生血管的诊断价值

Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.     

光学相干断层扫描在经瞳孔温热疗法治疗老年性黄斑变性中的应用

目的　探讨光学相干断层扫描 (OCT)对经瞳孔温热疗法 (TTT)治疗渗出型老年性黄斑变性 (AMD )的临床应用价值。方法　对渗出型AMD3 5例 ( 3 6眼 )进行光学相干断层扫描(OCT)、荧光素眼底血管造影 (FFA)、吲哚青绿脉络膜血管造影 (ICGA )检查。根据FFA、ICGA和OCT检查结果 ,明确CNV位置、范围和大小 ,采用半导体红外激光 ( 810nm)进行TTT治疗 ,并对其疗效进行评价。结果　TTT治疗后视力提高者 10眼 ,占 2 7 8% ;视力稳定不变者 17眼 ,占47 2 % ;视力下降者 9眼 ,占 2 5 %。OCT复查结果为 11眼 ( 3 0 6% )黄斑水肿消失 ;14眼( 3 8 9% )黄斑水肿减轻 ;8眼 ( 2 2 2 % )无变化 ;3眼 ( 8 3 % )黄斑水肿加重。CNV消失 12眼( 3 3 3 % ) ,CNV缩小 19眼 ( 5 2 8% ) ,CNV无变化 3眼 ( 8 3 % ) ,CNV增大 2眼 ( 5 6% ) ;治疗后视网膜厚度明显变薄 (P <0 0 0 1)。黄斑中心凹视网膜神经上皮层厚度与视力呈负相关 (r =0 4963 ,P =0 0 0 1)。结论　OCT可客观、精确地显示CNV的位置、大小范围及视网膜水肿的变化程度 ,对指导TTT治疗AMD和疗效评价有着重要价值。     

OCT对光动力疗法治疗CNV的疗效评估

目的：观察光学相干断层扫描(optical coherence tomography,OCT)评估光动力疗法(photodynamic therapy,PDT)治疗老年黄斑变性(age-related macular degeneration,AMD)、病理性近视(pathological myopia, PM)和中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy,CEC)引起的脉络膜新生血管(choroidal neovascularization,CNV)视网膜的疗效和安全性。

方法：回顾分析2010-01/2012-12经视力、眼压、荧光素眼底血管造影(fundus fluorescein angiography,FFA)、吲哚青绿血管造影(indocyanine green angiography,ICGA)和OCT检查,临床确诊为有CNV形成的临床患者资料,共53例53眼符合条件纳入观察。患者经PDT治疗后,每3mo进行随访复查,复发的患者再次进行PDT治疗。对比分析治疗前与治疗后1a患者最佳矫正视力(BCVA)及黄斑中心视网膜厚度(central macular thickness,CMT)的改变。

结果：截止随访结束时,患者经PDT治疗后,最佳矫正视力均比治疗前提高35例,视力稳定无明显变化15例,视力下降3例; 所有患者眼底渗漏均减轻,经FFA检查42例患者CNV闭合且渗漏完全停止,11例患者CNV大部分闭合。治疗前后患者视力及CMT改变均有统计学意义。整个治疗及随访中所有患者均未见与接受PDT治疗相关的眼部和全身不良反应。

结论：PDT治疗AMD患者CNV能够在1a内保持视力的稳定,且严重不良事件的发生率低,是AMD 患者CNV治疗的安全有效方法。     

光动力疗法治疗渗出性年龄相关性黄斑变性

目的观察光动力疗法(photodynamic therapy,PDT)治疗渗出性年龄相关性黄斑变性(age-related macular degeneration,AMD)的疗效。方法回顾分析经荧光素眼底血管造影(fundus fluorescein angiography,FFA)、吲哚菁绿血管造影(indocyanine green angiography,ICGA)以及光学相干断层扫描(optical coherence tomography,OCT)检查确诊的21例(31眼)渗出性AMD患者PDT治疗前及治疗后的临床资料,主要以视力、FFA及(或)ICGA、OCT的改变为观察指标,评价PDT对渗出性AMD的治疗效果。结果治疗后13眼视力明显改善(视力提高≥2行),占41.9%;14眼视力稳定不变(视力波动在1行以内),占45.2%;4眼视力下降2行,占12.9%。大部分患眼于PDT治疗后眼底出血和渗出减轻;ICGA检查显示:PDT治疗后1周,16眼CNV的渗漏明显减少或完全停止,8眼渗漏完全停止。OCT检查显示:CNV周围视网膜脉络膜水肿以及神经上皮脱离好转。5例6眼患者在PDT治疗过程中及治疗后发生视网膜神经上皮脱离范围变大,1例1眼发生黄斑部再次大面积出血,所有病例均未发生任何全身不良反应。结论单次和重复PDT治疗可以部分或完全封闭渗出性AMD的CNV,PDT治疗对病灶周围的正常视网膜和脉络膜组织短期内有轻度影响,对视力无损害。     

光动力疗法治疗中心性渗出性脉络膜视网膜病变的临床观察

目的:评价光动力疗法(photodynamic therapy,PDT)对中心性渗出性脉络膜视网膜病变(central exudative chorioreti-nopathy,CEC)的临床疗效观察。方法:回顾36例36眼经眼底检查、荧光血管造影检查(fundus fluorescein angiorgam,FFA)和吲哚青绿眼底血管造影检查(indocyanine green angiography,ICGA)确诊为CEC的患者,36眼接受PDT治疗前后,对比分析治疗前后的临床资料,观察PDT治疗的有效性和安全性。结果:PDT治疗后视力明显改善者20眼(55.6%),视力稳定者14眼(38.9%),还有2眼(5.5%)视力下降。眼底检查发现病灶明显缩小,出血渗出吸收。FFA显示脉络膜新生血管(choroidal neovascularization,CNV)病灶闭合,只有1眼出现病灶扩大。结论:PDT治疗CEC在大多数患者是安全有效的。     

光动力治疗中心性渗出性脉陇视网膜炎的临床观察

目的光动力疗法(photodynamic therapy,PDT)对中心性渗出性脉络膜视网膜炎(central exudative chorioretinopathy CEC)的临床治疗观察。方法14例,14只眼经眼底检查、荧光眼底血管造影(fundus fluorescein angiography,FFA)、吲哚青绿血管造影(indocyanine green angiography,ICGA)检查确诊为中心性渗出性脉络膜视网膜炎(central exudative chorioretinopathy,CEC)的患者14只眼进行治疗,患者年龄18-38岁,平均年龄28.2岁,最佳矫正视力0.1-0.5之间,光敏剂苯丙扑啉衍生物单酸。6mg/m2静脉滴注10min,开始静脉用药后15min,通过裂隙灯用强度为50J/cm2,波长为689nm激光,照射83s。治疗后患者尽可能避光48-72h,治疗后7d开始复查,随访3个月,并在3个月时进行眼底检查、FFA、ICGA等全面检查。结果治疗后,10只眼(71.4%)视力有明显提高,7只眼(50%)在1个月左右时视力有所波动。OCTFFAICGA检查结果显示,光动力治疗后大部分病例CNV静止或萎缩,但一部分病例仍可见CNV残骸及局部的色素上皮囊样变性。多焦视网膜电图(multifocal electroretinography mERG)1-5环N1、P1波振幅密度值与治疗前均有显著差异(P<0.05),PDT治疗后7d的mfERGN1波、P1波幅密度与治疗前比较均无明显差异(P>0.05)。两组PDT治疗前后各时间点mfERGN1波、P1波潜峰时无显著差异(P>0.05)。结论PDT治疗中心性渗出性脉络膜视网炎(CEC)有波动现象。PDT治疗早期观察对黄斑神经上皮感觉层损伤不明显。PDT治疗中心性渗出性脉络膜视网炎(CEC)短期疗效满意。     

特发性脉络膜新生血管光动力疗法的疗效观察

目的观察光动力疗法（PDT）对特发性脉络膜新生血管（CNV）的治疗效果。方法对61例（61只眼）经荧光素眼底血管造影（FFA）和吲哚氰绿眼底血管造影（ICGA）确诊的特发性CNV患者行PDT治疗,观察比较治疗前后眼底形态、视力、视网膜厚度、FFA和ICGA图像特征。PDT平均治疗次数为1、2次。随访时间为6～36个月,平均19个月。结果末次随访时,61只眼中,有41只眼视力提高（67.2％）,15只眼视力无明显变化（24.6％）,5只眼视力下降（8.2％）。经治疗后所有患眼黄斑出血及渗出均明显减轻。FFA图像显示38只眼的CNV荧光素渗漏完全消失,CNV闭合或瘢痕形成（62．3％）;4只眼CNV部分闭合（6.6％）,14只眼CNV小部分闭合（23．0％）,5只眼CNV复发（8．2％）。6只眼经1次PDT治疗CNV完全闭合,相干光断层扫描或视网膜厚度检查可见黄斑区神经上皮脱离及视网膜水肿消失,随访时间最长3年,未见CNV复发,视力保持稳定。研究结果经多重线性回归分析,表明治疗效果与年龄有关（t=0．476,P=0．016）,即年龄每提高一岁,治疗后视力平均下降0．008（95％CI为0．002～0．015）。结论PDT对特发性CNV有较好的治疗效果,特别对年轻患者效果更好些。（中华腰科杂志,2007,43：509-513）     

Optical coherence tomography analysis of bilateral end-stage choroidal neovascularization where one eye is treated with photodynamic therapy

BACKGROUND: To compare retinal thickness and subretinal hyper-reflectivity using Stratus optical coherence tomography (OCT3) between the eyes of patients with bilateral end-stage exudative age-related macular degeneration (AMD), where one eye has been treated with photodynamic therapy (PDT). METHODS: Patients with PDT-treated stable choroidal neovascularization (CNV), defined as a fibrotic lesion not requiring treatment for 6 months, in one eye and an untreated end-stage CNV (disciform) scar in their fellow eye, underwent refraction protocol logMAR visual acuity (VA) in letters, slit-lamp biomicroscopy, fluorescein angiography and OCT3 scan. Subretinal scar thickness was measured as Outer High Reflectivity Band Thickness (OHRBT) and retinal thickness as neuroretinal foveal thickness (NFT) on OCT3. RESULTS: Thirty-two eyes of 16 patients were studied. Mean OHRBT was 255.62 microm in treated eyes and 350.8 microm in untreated eyes (P = 0.001). Mean NFT was 130.3 microm in the treated eye and 79.9 microm in the untreated eye (P = 0.017). Mean VA was 42 letters in treated eyes and 15 letters in untreated eyes (P < 0.005). CONCLUSION: Based on OCT3 findings, eyes with AMD treated with PDT have a thinner fibrous scar and better preserved retinal thickness when compared with untreated fellow eyes with end-stage fibrotic scarring.