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目的 观察光动力疗法 (photodynamic therapy,PDT)对渗出型老年性黄斑变性 (age- relatedmacular degeneration,AMD)脉络膜新生血管 (choroidal neovascularization,CNV)进行单次和多次治疗的临床疗效。 方法 2 0例经双目间接立体检眼镜、荧光素眼底血管造影 (fundus fluorescein angiography,FFA)、吲哚青绿血管造影 (indocyanine green angiography,ICGA)检查确诊的 AMD患者的 31只患眼纳入治疗。患者年龄 4 7～ 88岁 ,平均年龄 6 8.1岁 ,最佳矫正视力在数指 /10 cm～ 0 .6之间。光敏剂苯并卟啉衍生物单酸 (benzoporphyrin derivative mono acid,BPD) (中国诺华公司 ) 6 mg/m2静脉滴注 10 min,开始静脉用药后 15 min,通过裂隙灯用强度为 5 0 J/cm2 的 6 89nm激光 (德国 Zeiss公司 )照射 83s。治疗后患者尽可能避光 4 8h。治疗后 2周开始复查 ,每 3个月随访 1次 ,随访时间最短 3个月 ,最长 18个月 ,平均随访12个月。FFA和 (或 ) ICGA显示病灶范围扩大、或渗漏增加 ,即进行重复 PDT治疗。其中 1只眼进行了 4次治疗 ,4只眼进行了 2次治疗 ,其余 2 6只眼均只进行了 1次治疗。 结果 治疗后 13只眼视力明显改善(视力提高≥ 2行 ) ,占 4 1.9% ;17只眼视力稳定不变 (视力波动在 1行以内 ) ,占 5 4 .8% ;
Objective To observe the clinical efficacy of photodynamic therapy (PDT) on single and multiple treatment of age-related macular degeneration (AMD) choroidal neovascularization (CNV). Methods Twenty - one eyes of 31 patients with AMD diagnosed by binocular indirect ophthalmoscopy, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were included in the study. Patients aged 47 to 88 years old, mean age 6 8.1 years, the best corrected visual acuity in the number of fingers / 10 cm ~ 0.6 between. The dose of 6 mg / m2 of benzoporphyrin derivative mono-acid (BPD) was intravenously injected for 10 min, and the intensity of the slit lamp was 50 J / cm2 of 6 89nm laser (Zeiss, Germany) for 83s. After treatment, patients as far as possible light 4 8h. The treatment started 2 weeks after the review, every 3 months follow-up 1, the shortest follow-up time of 3 months, a maximum of 18 months, an average of 12 months follow-up. FFA and / or ICGA showed an increase in the extent of the lesion or increased leakage, ie, repeat PDT. One of them had 4 treatments, 4 had 2 treatments and the other 26 had only 1 treatment. Results After treatment, the visual acuity of 13 eyes improved obviously (visual acuity ≥ 2 lines), accounting for 4 1.9%. The visual acuity of 17 eyes was stable (visual acuity fluctuated within 1 line), accounting for 54.4%.