發(fā)布時間：2018-05-13 19:05

  本文選題：光動力學(xué)療法 + 慢性中心性漿液性脈絡(luò)膜視網(wǎng)膜病變　； 參考：《眼科新進展》2017年04期

【摘要】：目的比較半劑量維替泊芬光動力與半能量光動力療法(photodynamic therapy,PDT)對慢性中心性漿液性脈絡(luò)膜視網(wǎng)膜病變(central serous chorioretinopathy,CSC)治療的有效性和安全性。方法回顧性隊列病例研究。將我院門診確診為慢性CSC患者42例(42眼)納入研究。根據(jù)患者PDT治療過程中所接受的藥物劑量和激光參數(shù)的不同分為半劑量和半能量組。半劑量組22例(22眼)接受半劑量維替泊芬(3 mg·m~(-2))和標準能量PDT(83 s,50 J·cm~(-2))治療。半能量組20例(20眼)接受全劑量維替泊芬(6 mg·m~(-2))和半能量PDT(42 s,25 J·cm~(-2))治療。PDT治療后1、3、6個月隨訪,觀察兩組患者視網(wǎng)膜下液(subretinal fluid,SRF)完全吸收的比例,最佳矯正視力(best corrected visual acuity,BCVA)變化和黃斑部視網(wǎng)膜厚度(central macular thickness,CMT)的變化。結(jié)果治療后6個月,半劑量組患者22眼(100%)SRF完全吸收,半能量患者19例(95%)SRF完全吸收,兩組間治愈率比較差異無統(tǒng)計學(xué)意義(P0.05);治療后6個月,半劑量組BCVA提高7.2字母,半能量組BCVA提高6.7個字母,BCVA提高字母數(shù)兩組間比較差異無統(tǒng)計學(xué)意義(P0.05)。治療前半劑量組CMT為(351±90)μm,治療后6個月降至(178±55)μm,治療前后比較差異有統(tǒng)計學(xué)意義(P0.05),半能量組CMT治療前為(322±96)μm,治療后6個月降至(181±47)μm,治療前后比較差異有統(tǒng)計學(xué)意義(P0.05)。所有患者均未出現(xiàn)視網(wǎng)膜色素上皮萎縮、脈絡(luò)膜新生血管形成等并發(fā)癥。結(jié)論半劑量維替泊芬光動力和PDT治療慢性CSC同樣安全有效。
[Abstract]:Objective to compare the efficacy and safety of half dose vitipofen photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (serous). Methods retrospective cohort study. 42 patients with chronic CSC (42 eyes) were included in the study. The patients were divided into half dose and half energy groups according to the drug dose and laser parameters received during the treatment of PDT. Half dose group (22 eyes) were treated with metipofen (3 mg / ml) and standard energy (PDT(83 / 50 J / cm ~ (-2). In the half-energy group (n = 20, n = 20) received full dose of metipofen (6 mg / ml) and half-energy PDT(42 (25 J 路cm ~ (-2). The patients were followed up for 1, 3 and 6 months after treatment. The complete absorption ratio of subretinal fluid (SRF) was observed in both groups. Changes of best corrected visual acuity and central macular thickness of macular retina. Results after 6 months of treatment, 22 eyes of the half-dose group were completely absorbed, and 19 cases of half-energy patients were completely absorbed. There was no significant difference in the cure rate between the two groups (P 0.05), and the BCVA in the half-dose group increased 7.2letter at 6 months after treatment. There was no significant difference between the two groups in the increase of BCVA and the number of letters in the half energy group (P 0.05). The CMT of the first half dose group was 351 鹵90 渭 m, and decreased to 178 鹵55 渭 m 6 months after treatment. The difference was statistically significant before and after treatment (P 0.05). The CMT in the half energy group was 322 鹵96 渭 m before treatment and 181 鹵47 渭 m at 6 months after treatment. There was a significant difference before and after treatment (P 0.05). No complications such as retinal pigment epithelium atrophy and choroidal neovascularization were found in all patients. Conclusion the half dose of vitipofen photodynamic therapy is as safe and effective as PDT in the treatment of chronic CSC.
【作者單位】： 西安市第四醫(yī)院眼科;
【基金】：陜西省科技廳社會發(fā)展科技攻關(guān)項目(編號:2015SF232;2015SF085;2015SF106) 西安市科技局社會發(fā)展引導(dǎo)計劃-醫(yī)學(xué)研究項目[編號:SF1513(3)]~~
【分類號】：R774.1

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