光动力疗法治疗病理性近视脉络膜新生血管的临床观察

目的 探讨光动力疗法(PDT)治疗病理性近视(PM)黄斑部脉络膜新生血管(cNV)短期的安全性和有效性.方法 回顾经临床眼底检查、FFA和/或ICGA检查及确诊的继发于PM的CNV患者19例(19只眼)行PDT治疗前后的临床资料,对比分析其最佳矫正视力、眼底像、眼底血管造影CNV渗漏、OCT及mf-ERG检查结果.光动力治疗方案参照TAP制定的标准.随访时间为3-6个月.结果 PDT治疗后全部患者视力改善或保持不变,无视力下降者.所有患眼底出血或渗出均减轻.FFA/ICGA检查显示:CNV停止渗漏11只眼,占57.89%;渗漏减少8只,占42.11%.OCT检查显示CNV明显变薄.PDT治疗后1个月mf-ERG3-5环N1、P1波波振幅密度值与治疗前均有显著提高(P＜0.05),3个月时3～4环N1、P1波振幅密度值与治疗前均有显著提高(P＜0.05).结论 病理性近视CNV经PDT治疗短期有效,安全性好,PDT治疗CNV的长期疗效有待进一步观察.

Clinical study of choroidal neovascularization in pathological myopia treated with photodynamic therapy

Objective To observe the efficacy and safety of photodynamic therapy with verteporfin for choroidal neovascularization.Methods Clinical data of 19 pathologic myopia (PM) cases (19 eyes) were included.They diagnosed as active choroidal neovascularization (CNV) by fluorescein angiography (FFA) and/or indocyanine green angiography ( ICGA).The analysis parameters for post PDT therapy efficaay and safety were,best corrected visual acuity(BCVA), fundus manifestations,FFA and ICGA,Optic coherence tomogramphy(OCT) and multifocal electroretinogram (mfERG). The therapy methods refered to TAP protocol.Follow-up time varied from 3 month to 6 months.Results The BCVA was improved or stabilized.Fundus hemerrhoge and exudation reduced after PDT.FFA and ICGA showed CNV complete closure in 11 eye (57.89%),minimal leakage in 8 eyes(42.11%).The OCT showed CNV thinningzed.N1 and P1 wave peak amplitudes densities improved in ring 3-5 after treatment 1 months (P<0.05),and improved in ring 3-4 after treat- ment 3 months.(P<0.05).Conclusion PDT is effective and safety for PM with CNV.The long-term efficacy of PDT for CNV remains for further study.