光动力疗法治疗有无伴发黄斑囊样水肿脉络膜新生血管的疗效观察

摘要

目的 观察光动力疗法(PDT)治疗渗出型老年性黄斑变性(AMD)脉络膜新生血管(CNV)有无伴发黄斑囊样水肿(CME)的临床疗效.方法 回顾分析经临床确诊为渗出型AMD并接受PDT治疗的的44例患者54只眼的临床资料.其中,CNV伴黄斑CME者16例21只眼,不伴CME者28例33只眼.所有患者治疗前及治疗后每3个月采用糖尿病早期治疗研究(ETDRS)视力表检查视力、光相干断层扫描(OCT)检测黄斑水肿和黄斑中心小凹处层间厚度(BFT).治疗后随访3～18个月,平均随访8.3个月.结果 末次随访时,伴CME组ETDRS字母数为(29.429零±17.907)个,与治疗前相比,差异无统计学意义(t=0.389,P=0.701);OCT检查显示BFT为(316.429±77.161) μm,与治疗前相比,差异有统计学意义(t=2.246,P=0.019).不伴CME组ETDRS字母数为(48.121±17.911)个,OCT检查显示BFT为(244.667±37.619) μm,与治疗前相比,差异均有统计学意义(t=-3.424,6.880;P=0.002,0.000).两组间治疗前后ETDRS视力提高字母数和BFT提高值差异均有统计学意义(t=-2.194,2.212;P=0.033,0.031).结论 PDT治疗渗出型AMD CNV不伴CME患者的临床疗效优于CNV伴CME者.%Objective To observe the therapeutic effects of photodynamic therapy(PDT)on ehoroidalneovascularization(CNV) with or without cystoid macular edema (CME)in patients with wet age-related macular degeneration(AMD).Methods The clinical data of 54 patients (54 eyes) with wet AMD who had undergone the standard PDT,including 16 patients (21 eyes) with CME and 28 patients (33 eyes) without CME were retrospectively analyzed.The visual acuity and BFT of patients were examined by early treatment diabetic retinopathy study (ETDRS) and optical coherence tomography(OCT)before and per three months after PDT.The follow-up was 3-18 months with the mean of 8.3 months.Results At the last time of follow-up,in CME group,ETDRS letter score was(29.429±17.907) and the BFT was (316.429±77.161) μm,compared with that before the treatment,the difference were statistically significant (t=-0.389,2.246;P=0.701,0.019).In non-CME group,ETDRS letter score was (48.121±17.911) and the BFT was (244.667±37.619) μm,compared with that before the treatment,the difference were statistically significant (t=-3.424,6.880;P=0.002,0.000).There were statistical significance for the change of ETDRS letter score and BFT between the two groups (t=-2.194,2.212,P=0.033,0.031)).Conclusions Therapeutic effect of PDT on CNV with CME was better than without CME in patients with wet AMD.