目的:评价光动力疗法(photodynamic therapy,PDT)治疗病理性近视所致黄斑部脉络膜新生血管(choroidal neovascularization,CNV)的临床疗效。方法:回顾性分析20例21眼临床确诊为病理性近视合并CNV患者的临床资料,对比分析PDT治疗前后患者最佳矫正视力(BCVA)、固视性质,FFA/ICGA和OCT等检查结果的变化。结果:PDT治疗后随访6mo,1例患者PDT治疗后3mo因玻璃体积血行玻璃体切除手术,未继续随访。其余患者BCVA与治疗前相比明显提高,差异具有统计学意义(P<0.05)。PDT治疗前中心固视3眼,中心外固视18眼,随访期间固视性质未发生改变。FFA/ICGA检查显示,PDT治疗后3mo,CNV病灶渗漏停止或渗漏减少者18眼(86%),持续渗漏2眼(10%),1眼出现玻璃体积血。PDT治疗后6mo,CNV病灶渗漏停止或渗漏减少者19眼(90%),持续渗漏1眼(5%),OCT显示CNV缩小,组织水肿减轻。结论:PDT治疗可以部分或完全封闭病理性近视所致脉络膜CNV,减少CNV引起的视力下降危险性。

AIM:To investigate the efficacy of photodynamic therapy(PDT) on macular choroidal neovascularization(CNV) of pathologic myopia(PM).METHODS:Twenty patients 21 eyes who were diagnosed with PM were analyzed retrospectively.The changes in the best-corrected visual acuity(BCVA),fixation nature,fundus examination,FFA/ICGA and OCT were analyzed before and after PDT treatment.RESULTS:During 6 months follow-up,only 1 case was performed vitrectomy because of vitreous hemorrhage 3 months after PDT.Compared with pre-treatment of PDT,the BCVA of other patients was improved(P<0.05).Before PDT treatment,3 eyes were central fixation and 18 eyes were paracentral fixation.The fixation characteristic was not changed after PDT.3 months after PDT,FFA/ICGA showed no leakage or reduced leakage in 18 eyes(86%).In 2 eyes,the fundus remained leaky,1 eye was not followed because of vitreous hemorrhage and performing vitrectomy.In the six-month follow-up,FFA/ICGA showed no leakage or slight leakage in 19 eyes(90%) and continous leakage in 1 eye(5%).CONCLUSION:PDT can block CNV of PM completely or partly,and reduce the danger of vision loss.

R778.11