论文部分内容阅读
目的总结2002年7月至2005年3月光动力疗法(PDT)治疗渗出型老年黄斑变性(AMD),重复治疗病例的疗效和临床特点。方法回顾分析渗出型AMD患者78例94只眼采用PDT治疗,患者平均年龄68.4岁,治疗次数为132次,平均1.4次,其中22例30只眼接受重复PDT治疗,占治疗总数31.9%。30只眼共进行PDT治疗68次,其中2次22只眼,占73.3%;3次7只眼,占23.3%;6次1只眼,占3.3%。随诊时间3~32个月,平均随诊时间16.7个月。结果PDT治疗后末次随诊检查时,荧光素眼底血管造影(FFA)或FFA联合吲哚青绿血管造影(ICGA)检查显示CNV渗漏停止14只眼,占46.7%;渗漏减少12只眼,占40%;持续渗漏4只眼,占13.3%。与首次PDT治疗前相比,末次检查矫正视力提高≥2行7只眼,占23.3%;视力波动在上下1行以内14只眼,占43.3%;视力下降≥2行9只眼,占30%。首次PDT后最佳矫正视力13只眼视力提高≥2行,占43.3%;12只眼视力波动在上下1行之内,占40%;5只眼视力下降≥2行,占16.7%。在随诊期中,最佳矫正视力出现在首次PDT后24只眼,占80%;有5只眼出现在2次PDT后,占16.7%;1只眼出现在3次PDT后,占3.3%。结论在重复PDT治疗患者中,末次随诊检查大部分眼CNV能完全或部分闭合,视力提高和维持者占67.8%,最佳矫正视力多出现在首次PDT后,随着PDT治疗次数的增加,最佳矫正视力出现的概率减小。
Objective To summarize the curative effect and clinical features of PDT in the treatment of exudative age-related macular degeneration (AMD) from July 2002 to March 2005. Methods Retrospective analysis of 78 patients with exudative AMD in 78 patients with PDT treatment, the average age of 68.4 years, the treatment of 132 times, an average of 1.4 times, of which 22 cases of 30 eyes received repeated PDT treatment, accounting for a total of 31.9% of the total. Thirty eyes were treated with PDT for 68 times, of which 22 eyes were twice, accounting for 73.3%; 3 eyes, accounting for 23.3%; 6 eyes, accounting for 3.3%. Follow-up time of 3 to 32 months, the average follow-up time of 16.7 months. Results During the last follow-up examination after PDT, fundus fluorescein angiography (FFA) or FFA combined with indocyanine green angiography (ICGA) showed that 14 eyes of CNV leakage stopped (46.7%), 12 eyes reduced, Accounting for 40%; continuous leakage of 4 eyes, accounting for 13.3%. Compared with the first PDT, the corrected visual acuity of the last examination was ≥2 rows and 7 eyes, accounting for 23.3%; the visual acuity fluctuated within 14 eyes in 1 row and in the top row, accounting for 43.3%; the visual acuity decreased ≥2 rows and 9 eyes, accounting for 30% %. After the first PDT, the corrected visual acuity of 13 eyes improved by ≥2 lines, accounting for 43.3%. The visual acuity of 12 eyes was within 40% of the upper and lower lines, while the visual acuity of the 5 eyes decreased by 2 lines or 16.7%. During the follow-up period, the best corrected visual acuity occurred in 24 eyes after the first PDT, accounting for 80% of the total. Out of the 5 eyes, 16.7% were seen after 2 PDTs and 1 eye was 3.3% after 3 PDTs. . Conclusion In the patients with repeated PDT, CNV of most eyes can be completely or partially closed at the last follow-up examination. The improvement of visual acuity and maintainer accounted for 67.8%. The best corrected visual acuity occurred mostly after the first PDT. With the increase of PDT, The best corrected visual acuity appears to reduce the probability.