光动力疗法联合曲安奈德治疗脉络膜新生血管性疾病的短期疗效研究

发布时间：2019-06-24 14:09

【摘要】：目的观察使用维替泊芬光动力疗法(photodynamic therapy, PDT)联合曲安奈德(triamcinolone acetonide,TA)治疗年龄相关性黄斑变性(age-related macular degeneration,AMD)、病理性近视和特发性脉络膜新生血管(choroidal neovascularization, CNV)等3种主要的CNV相关疾病的临床效果方法采用多因素对照性研究方法进行试验。本研究选择了影响PDT治疗后视力恢复的5种可能因素进行研究，包括按病因分类：AMD(PCV)、PM、ICNV；术前初始视力：0.1、0.1~0.3、0.3；病程：1、1~3、3月；病变GLD；荧光素眼底血管造影分型：经典为主型、微小经典型、隐匿型。运用SPSS统计软件,对影响PDT治疗后1、3、6mo最佳矫正视力可能的相关因素进行多元回归分析。经临床确诊的71例(82眼)的CNV患者行维替泊芬PDT治疗，随访1～6mo。观察治疗前后患者的视功能、CNV病灶大小及渗漏情况、以及黄斑中心凹视网膜厚度(central macular thickness, CMT)等，，评价维替泊芬PDT治疗CNV的疗效。如果黄斑水肿明显，半球后注射曲安奈德20mg。结果本组病例包括年龄相关性黄斑变性39例(46眼)，病理性近视11例(13眼)，特发性脉络膜新生血管21例(23眼)。Amlser方格表检查82只眼均有视物变形。上诉3种疾病PDT治疗的平均次数分别为1.15，1.09和1.04次；按照病因分组，治疗后最佳矫正视力稳定和提高的患者各组分别为89.1%，92.3%和91.3%；CNV渗漏停止或减少者各组分别为89.1%，92.3%和95.6%：黄斑中心凹视网膜厚度CMT减轻者各组分别为79.4%，90.5%和88.1%。结论维替泊芬光动力疗法可有效地改善或稳定AMD、病理性近视和特发性CNV患者的视功能，控制病变进展，半年随访结果安全有效。曲安奈德球周注射能有效的抑制脉络膜新生血管、改善黄斑部视网膜水肿，安全性高，并发症发生率低。维替泊芬光动力疗法对治疗及时、视力0.1的脉络膜新生血管性疾病仍然有较好的疗效
[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
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R773.4

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