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目的 观察单次光动力治疗 (photodynamic therapy,PDT)对渗出型老年性黄斑变性 (age-related macular degeneration,AMD)脉络膜新生血管 (choroidal neovascularization,CNV)的近期治疗效果。 方法 回顾分析经荧光素眼底血管造影 (fundus fluorescein angiography,FFA)、吲哚青绿脉络膜血管造影 (indocyanine green angiography,ICGA)以及光学相干断层扫描 (optic coherence tomography,OCT)检查确诊的 5例渗出型 AMD患者的 7只患眼行 PDT治疗前及治疗后随访观察 1周和 1个月时的临床资料 ,主要以视力、FFA及 (或 ) ICGA、OCT的改变为观察指标 ,评价 PDT对渗出型 AMD的治疗效果。 结果 7只患眼在治疗后 1个月视力均无下降。治疗后 1周时除 1只眼在 ICGA后期仍可观察到 CNV有轻微渗漏外 ,其余 6只眼 FFA及 (或 ) ICGA均显示 CNV渗漏停止 ;OCT检查显示 CNV有不同程度缩小 ,CNV周围视网膜脉络膜水肿及神经上皮脱离明显好转。但在治疗后 1个月时观察到有 2只眼在原渗漏病灶处又有渗漏灶出现。 结论 PDT治疗可以在短期内封闭 AMD的 CNV,使其停止渗漏 ,且不影响视力。
Objective To observe the short-term therapeutic effect of single photodynamic therapy (PDT) on the age-related macular degeneration (AMD) choroidal neovascularization (CNV). Methods Five cases of exudative type confirmed by fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were retrospectively analyzed. The clinical data of 7 eyes of AMD patients before and after PDT were followed up for 1 week and 1 month. The changes of visual acuity, FFA and / or ICGA and OCT were regarded as the observation indexes to evaluate the effect of PDT on exudation AMD treatment effect. Results Seven eyes had no visual acuity one month after treatment. One week after treatment, CNV leakage was still observed in all but one of the four eyes at the later stage of ICGA. The other six eyes showed CNV leakage stopped in 6 eyes and the CNT Peripheral retinal choroidal edema and neuroepithelial detachment improved significantly. However, at 1 month after treatment, 2 eyes were observed at the site of the original leakage. Conclusions PDT can block CNV of AMD in a short period of time and stop it from leaking without affecting vision.