【摘要】：目的觀察使用維替泊芬光動(dòng)力療法(photodynamic therapy, PDT)聯(lián)合曲安奈德(triamcinolone acetonide,TA)治療年齡相關(guān)性黃斑變性(age-related macular degeneration,AMD)、病理性近視和特發(fā)性脈絡(luò)膜新生血管(choroidal neovascularization, CNV)等3種主要的CNV相關(guān)疾病的臨床效果 方法采用多因素對照性研究方法進(jìn)行試驗(yàn)。本研究選擇了影響PDT治療后視力恢復(fù)的5種可能因素進(jìn)行研究，包括按病因分類：AMD(PCV)、PM、ICNV；術(shù)前初始視力：0.1、0.1~0.3、0.3；病程：1、1~3、3月；病變GLD；熒光素眼底血管造影分型：經(jīng)典為主型、微小經(jīng)典型、隱匿型。運(yùn)用SPSS統(tǒng)計(jì)軟件,對影響PDT治療后1、3、6mo最佳矯正視力可能的相關(guān)因素進(jìn)行多元回歸分析。經(jīng)臨床確診的71例(82眼)的CNV患者行維替泊芬PDT治療，隨訪1～6mo。觀察治療前后患者的視功能、CNV病灶大小及滲漏情況、以及黃斑中心凹視網(wǎng)膜厚度(central macular thickness, CMT)等，，評價(jià)維替泊芬PDT治療CNV的療效。如果黃斑水腫明顯，半球后注射曲安奈德20mg。 結(jié)果本組病例包括年齡相關(guān)性黃斑變性39例(46眼)，病理性近視11例(13眼)，特發(fā)性脈絡(luò)膜新生血管21例(23眼)。Amlser方格表檢查82只眼均有視物變形。上訴3種疾病PDT治療的平均次數(shù)分別為1.15，1.09和1.04次；按照病因分組，治療后最佳矯正視力穩(wěn)定和提高的患者各組分別為89.1%，92.3%和91.3%；CNV滲漏停止或減少者各組分別為89.1%，92.3%和95.6%：黃斑中心凹視網(wǎng)膜厚度CMT減輕者各組分別為79.4%，90.5%和88.1%。 結(jié)論維替泊芬光動(dòng)力療法可有效地改善或穩(wěn)定AMD、病理性近視和特發(fā)性CNV患者的視功能，控制病變進(jìn)展，半年隨訪結(jié)果安全有效。曲安奈德球周注射能有效的抑制脈絡(luò)膜新生血管、改善黃斑部視網(wǎng)膜水腫，安全性高，并發(fā)癥發(fā)生率低。維替泊芬光動(dòng)力療法對治療及時(shí)、視力0.1的脈絡(luò)膜新生血管性疾病仍然有較好的療效
[Abstract]:Objective To observe the treatment of age-related macular degeneration (AMD), pathological myopia and idiopathic choroidal neovascularization (AMD) using a photodynamic therapy (PDT) and triamcinolone acetonide (TA). The clinical effect of three major CNV-related diseases, such as CNV Methods The multi-factor control method was used for the test. The five possible factors that affected the restoration of visual acuity after PDT were studied in this study, including: AMD (PCV), PM, ICNv, pre-operative initial vision: 0.1, 0.1-0.3, 0.3; course of course:1,1-3,3-month; lesion GLD; fluorescein fundus angiography: classic, small, typical, hidden Model: The relevant factors that influence the best corrected vision of 1,3 and 6 mo after PDT were analyzed by SPSS statistical software. Analysis of the clinical diagnosis of 71 cases (82 eyes) of CNV, with the follow-up of 1 to 6 m in the treatment of the patients with CNV. O. Observe the visual function of the patients before and after the treatment, the size and leakage of the CNV focus, and the central macular thickness (CMT) of the macula center, and evaluate the treatment of the CNV by the vitipofene PDT. Effect. If the macular edema is clear, the post-hemisphere injection of triamcinolone acetonide is 20 m g. The results of this group included 39 cases of age-related macular degeneration (46 eyes),11 cases of pathological myopia (13 eyes) and 21 cases of idiopathic choroidal neovascularization (2 3 eyes). The Amalser grid table examined 82 eyes. The mean number of the three kinds of disease PDT treatments were 1.15, 1.09 and 1.04 times, respectively, and 89.1%, 92.3% and 91.3% of the patients with the best corrected visual acuity after treatment, 89.1%, 92.3% and 95% respectively. .6%: 79.4%, 90.5%, and 88, respectively, of the CMTs in the fovea of the macula Conclusion Weitipofungin can effectively improve or stabilize the visual function of AMD, pathological myopia and idiopathic CNV, control the progression of the disease, and follow-up for half a year. It is safe and effective. The injection of triamcinolone acetonide can effectively inhibit the choroidal neovascularization, improve the retinal edema of the macular part, and has high safety. The incidence of the disease is low. The treatment of choroidal neovascular disease with visual acuity of 0.1 in a timely manner for the treatment of choroidal neovascular disease with visual acuity of 0.1
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R773.4

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