光动力学疗法治疗中心性渗出性脉络膜视网膜病变疗效观察

摘要

OBJECTIVE To evaluate the clinical effects of photodynamic therapy (PDT) with Verteporfin for central exudative chorioretinopathy (CEC). METHODS His study included forty-two patients(42 eyes) of CEC. The patients underwent OCT for the measurement of macular thickness and fundus fluorescein angiography (FFA) for the measurement of CNV diameter. One week, 1 month and 3 months after PDT, the macular thickness , leakage of CNV and best-corrected visual acuity (BCVA) were evaluated and compared. RESULTS 1. The thickness of macular central fovea was (446±67.2) |xm before treatment and (297±21.3) u,m 3 months after treatment. The difference was statistically significant (F<0.05). The thickness of macular central fovea was decreased after treatment in 25 eyes (59.5%). 2.The diameter of CNV leakage before treatment was (960±41.7)|xm, and(540± 25.7) |xm 3 months after treatment. The difference was statistically significant(F<0.05). The leakage of CNV disappeared in 28 eyes(66.7%), became smaller in 28 eyes(21.4%)and recurred in 5 eyes(11.9%). 3.The best corrected visual acuity (BCVA) was (4.32±0.11) before treatment and (4.74±0.17) 3 months later. The difference was statistically significant (P<0.05). BCVA was improved in 28 eyes (66.7%), remained stable in 9 eyes (21.4% )and became worse in 5 eyes (11.9%). CONCLUSIONS PDT with Verteporfin was effective in the treatment of CEC, but its long-term safety needs more observation.%目的 探讨维替泊芬联合光动力学疗法治疗中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy,CEC)的疗效.方法 CEC患者42例42只眼,光学相干断层扫描测量黄斑中心凹厚度,荧光素眼底血管造影测量脉络膜新生血管(choroidal neovascularization,CNV)渗漏病灶直径,行维替泊芬联合光动力学治疗(photodynamic therapy,PDT).治疗后1周、1个月、3个月复查,观察黄斑中心凹厚度、CNV病灶渗漏及最佳矫正视力的变化.结果 1.黄斑中心凹厚度:治疗前(446±67.2) μm,治疗后3个月(297±21.3) μm,差异有统计学意义(P＜0.05).黄斑中心凹厚度变小者25只眼(59.5％).2.CNV:治疗前CNV渗漏病灶直径(960±41.7) μm,治疗后3个月(540±25.7) μm,差异有统计学意义(P＜0.05).CNV完全闭合28只眼(66.7％),部分闭合9只眼(21.4％),复发5只眼(11.9％).3.视力:治疗前最佳矫正视力4.21±0.11(标准对数视力表),治疗后3个月时为4.74±0.17,前后差异有统计学意义(P＜0.05).治疗后3个月时视力疗效:视力提高28只眼(66.7％),稳定9只眼(21.4％),下降5只眼(11.9％).结论 维替泊芬联合PDT治疗CEC具有较好的疗效,但该治疗方法的长期安全性和有效性有待于进一步观察.