OBJECTIVE To evaluate the efficacy of intravitreal injection of ranibizumab combined with photodynamic therapy (PDT) on patients with polypoid choroidal vasculopathy (PCV).METHODS From January 2013 to June 2015,the included 60 patients with PCV were randomly divided into three groups.Group A was treated by photodynamic therapy,group B was administered by intravitreal injection of ranibizumab and group C were managed by combination of the two therapies simultaneously.The patients were followed up at 1 week,1 month,3 months and 6 months after treatment.The changes of corrected visual acuity (LogMar) and macular retinal thickness (CRT) were compared between three groups.RESULTS There were significant differences of visual acuity variation at different time points between the three groups (repeated analysis of variance analysis,by group:F=10.230,P＜0.001;by time:F=124.000,P＜0.001;by interaction:F=3.355,P=0.001).The visual acuity of all groups was improved after therapy (P＜0.05).There was fluctuation of LogMAR visual acuity in group A and B after therapy,but generally,it of group B was better than that of group A (P＜0.05).The level of LogMAR in group C decreased significantly and stabilized 3 month after therapy which was better than that of group A and B (P＜0.05).The variations of CRT of all groups at different time point were also not in equal level (by group:F=25.720,P＜0.001;by time:F=66.900,P＜0.01;by interaction:F=4.101,P＜0.01).The CRT value of three groups all decreased significantly after treatment (P＜0.05).It of group B decreased in the first place and then increased,and the decreasing magnitude of group A and group C were significantly greater than that in group B one month after therapy (P＜0.05).From then on the decline became smooth and continuous.The CRT of group C was lower than that of group A at each time point after treatment,but the differences were not statistically significant (P＞0.05).CONCLUSIONS Combined therapy covered the shortage of constituent therapies alone on PCV.It had advantages in alleviating macular edema and maintaining long term vision.CONCLUSIONS Combination therapy of PCV can make up for the deficiency of monotherapy.It has certain advantages in alleviating macular edema and maintaining long-term vision.%目的 探讨玻璃体腔注射雷珠单抗联合光动力疗法对息肉样脉络膜血管病变(PCV)的疗效.方法 2013年1月-2015年6月在我院就诊治疗的PCV患者60例,随机分为三组,A组患者给予光动力疗法治疗,B组患者给予玻璃体腔注射雷珠单抗治疗,C组患者给予联合治疗,治疗后1周、1个月、3个月、6个月进行随访,比较三组患者治疗后矫正视力(LogMar)、黄斑中心视网膜厚度(CRT)的变化情况.结果 三组患者不同时间的视力差异不同(重复测量资料的方差分析,F分组=10.230,P＜0.01;F时间=124.000,P＜0.01;F交互作月=3.355,P=0.01),治疗后三组各时间矫正视力均好于治疗前(P＜0.05),A、B组患者治疗后LogMAR视力水平存在一定波动,总体上B组好于A组;C组患者LogMAR水平下降幅度较大,在治疗后3个月趋于平稳,并好于A、B组(P＜0.05).三组患者不同时间的CRT差异也不相同(重复测量资料的方差分析,F分组=25.720,P＜0.01;F 时间=66.900,P＜0.01;F交互作用=4.101,P＜0.01),治疗后各组各时间的CRT数值亦均较治疗前降低(P＜0.05),B组CRT值呈先下降后上升的趋势,A、C组治疗后1个月的CRT下降幅度明显大于B组(P＜0.05),此后开始趋于平稳并继续下降.C组治疗后各时间的CRT低于A组,但二者差异无统计学意义(P＞0.05).结论 联合疗法治疗PCV可以弥补单一疗法的不足,其在减轻黄斑水肿及保持远期视力方面有一定优势.
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