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 探讨病理性近视脉络膜新生血管采用光动力疗法（PDT）治疗的临床效果.方法 选择病理性近视脉络膜新生血管患者20例（20眼）,均采用PDT治疗,回顾性分析治疗前后临床资料.结果 末次随访时,检测视力呈＞2行提高者3眼,占15％;保持稳定者16眼,占80％;视力下降1眼,占5％.眼底检查示视网膜神经感觉层缩小或脱离,黄斑渗出、水肿、出血均有程度不等的吸收.视网膜出血在治疗6个月后基本吸收.眼底荧光血管造影（FFA）/吲哚青绿血管造影（ICGA）在治疗后3个月检查显示,12只眼黄斑下脉络膜新生血管（CNV）荧光素渗漏静止,CNV闭合占60％,9只眼CNV渗漏好转,占45％.结论 CNV采用PDT治疗可获得理想效果,因为短期观察,选取的病例数相对较少,而从根本上,PDT无法杜绝CNV发生,故存在未彻底治疗的情况,长时间不能完全消失,也不能改善远期视力,若需客观评价PDT疗法,需行远期观察.

Clinical observation of photodynamic therapy for pathologic myopia choroidal neovascularization

Objective To investigate the effect of photodynamic therapy on pathological myopia choroidal neovascularization.Methods Twenty patients with choroidal neovascularization pathologic myopia were taken photodynamic therapy,the clinical data before and after treatment were analyzed retrospectively.Results At last follow-up,testing visual acuity was 〉 2 lines improved in three eyes（15%） ;remained stable in 16 eyes （80%） ; decreased vision in one eye,accounting for 5 %.Fundus examination showed that neurosensory retina reduced or detached.Macular exudation,edema,hemorrhage had varying degrees of absorption.Retinal hemorrhage were mainly absorbed six months after treatment.Three months after treatment,FFA / ICGA showed that 12 eyes（60%） still have CNV fluorescein leakage,CNV closure,CNV leakage improved in 9 eyes （45%）.Conclusions The effect of PDT on CNV is good,because the short-term observation,the number of patients is few,and PDT can not prevent CNV＇ s occurring and without completely cured,so the symptoms won＇ t completely disappear,and it can＇ t improve the long-term vision.If we evaluate the PDT therapy objectively,it need a long-term observation.