病理性近视黄斑部脉络膜新生血管光动力疗法治疗后光相干断层扫描观察结果分析

目的评价光相干断层扫描(OCT)检查在病理性近视(PM)所致的黄斑部脉络膜新生血管(CNV)光动力治疗(PDT)中的临床应用价值。方法对比分析25例PM患者28只患眼PDT治疗前后OCT图像中黄斑区视网膜高度及CNV复合体厚度,观察CNV与黄斑中心凹的关系。结果治疗前22只眼表现为CNV伴视网膜神经上皮水肿;2只眼为CNV合并神经上皮浆液性浅脱离;6只眼为CNV合并有视网膜层间出血。17只眼CNV位于中心凹处,11只眼位于中心凹旁。治疗后CNV强反光团逐渐缩小,神经上皮水肿或出血吸收,黄斑视网膜高度和CNV复合体厚度均显著降低(P值分别为0.02、0.03)。CNV复发表现为OCT图像中强反光团扩大,神经上皮水肿增厚,伴或不伴视网膜层间出血。结论OCT检查对于判定PM所致CNV的活动性以及决定是否进行PDT治疗和重复治疗有重要的辅助作用。

Analysis of features of optical coherence tomography after photodynamic therapy in choroidal neovascularization caused by pathologic myopia

Objective To evaluate the effect of optical coherence tomography (OCT) on the application of photodynamic therapy(PDT) for choroidal neovascularization(CNV) caused by pathologic myopia(PM).Methods The clinical data of 25 PM patients(28 eyes) who had undergone PDT and followed up over 6 months(mean 14.3 months) were analyzed retrospectively.All of the patients had been examined by OCT before and after PDT.The thickness of macular retina and CNV complex were measured and the relationship between CNV and macular fovea was investigated via OCT.Results Before the treatment,CNV accompanied with retinal neuroepithelial edema was found in 22 eyes,CNV accompanied with retinal neuroepithelial serous detachment was found in 2,and CNV accompanied with retinal interbedded hemorrhage;CNV was located at the fovea in 17 eyes and beside the fovea in 11. After PDT,the size of CNV shrank gradually,retinal neuroepithelial edema was alleviated and the hemorrhage was absorbed.The thicknesses of macular retina(P=0.02) and CNV complex(P=0.03) decreased significantly.The signs of recrudescence of CNV included the enlargement of CNV size,aggravation of retinal neuroepithelial edema,and being accompanied or not with retinal interbedded hemorrhage. Conclusion OCT is useful for indicating the activity of CNV caused by PM,and may serve as a complementary technique for deciding whether perform PDT or repeated the treatment.