吲哚青绿介导的光栓塞治疗黄斑中心凹下脉络膜新生血管

发布时间：2018-07-17 20:12

【摘要】：目的探讨吲哚青绿介导的光栓塞(indocyanine green-mediated photothrombosis,IMP)治疗黄斑中心凹下脉络膜新生血管(choroidal neovascularization,CNV)的疗效。方法选择特发性CNV(idiopathic CNV,I-CNV)和年龄相关性黄斑变性(age-related macular degeneration,AMD)伴黄斑中心凹下CNV(AMD with subfoveal CNV,A-CNV)患者共360例(432眼),分成光动力疗法(photodynamic therapy,PDT)治疗组(PDT组)、经瞳孔温热疗法(transpupillary thermotherapy,TTT)组、IMP组、IMP+玻璃体内注射曲安奈德(intravitreal triamcinolone acetonide,IVTA)组及对照组。通过眼底照相、光学相干断层扫描、荧光素眼底血管造影、吲哚青绿血管造影等检查观察CNV的消退情况,观察视力的变化,比较各种治疗效果。结果各组A-CNV患者治疗次数差异有统计学意义(P0.05)。对于ICNV,PDT组、TTT组、IMP组、IMP+IVTA组、对照组治疗前后具体的视力变化分别为0.13±0.11、0.09±0.12、0.12±0.14、0.19±0.15、0.10±0.12,各组之间视力差异无统计学意义(P0.05)。对于A-CNV,各组治疗前后具体的视力变化分别为0.23±0.14、0.13±0.10、0.18±0.09、0.19±0.11、0.03±0.03,各组间差异有统计学意义(P0.05)。PDT治疗组较其余各组可获得最好的视力效果;IMP联合或不联合IVTA的疗效其次,不如PDT组;TTT治疗组与其余各组比较,治疗效果最差;组间两两比较差异均有统计学意义(均为P0.05)。结论 IMP是一种治疗CNV的更为经济有效的替代方法,适合推广应用,特别是在基层医院。
[Abstract]:Objective to evaluate the efficacy of indocyanine green-mediated photothromboembolization (indocyanine green-mediated) in the treatment of choroidal neovascularization. Methods three hundred and sixty patients (432 eyes) with idiopathic with subfoveal A-CNV were divided into two groups: photodynamic therapy group (PDT), transpupillary thermotherapy group (transpupillary thermotherapy group) and transpupillary thermotherapy group (IMP group), which were divided into two groups: photodynamic therapy group (PDT group) and age-related macular degenerative macular degeneration group (age-related macular degenerative macular degeneration group) patients (432 eyes), who were divided into two groups: photodynamic therapy group (PDT group) and transpupillary thermotherapy therapy group (IMP group), which were divided into two groups: photodynamic therapy group (PDT group) and transpupillary thermotherapy group (IMP group). Triamcinolone acetonide (intravitreal triamcinolone acetonide) group and control group were intravenously injected with triamcinolone acetonide. Fundus photography, optical coherence tomography, fundus fluorescein angiography and indocyanine green angiography were used to observe the extinction of CNV, to observe the changes of visual acuity and to compare the therapeutic effects. Results the treatment times of A-CNV patients in each group were significantly different (P 0.05). The visual acuity of the control group before and after treatment was 0.13 卤0.110.09 卤0.12 卤0.12 卤0.14 卤0.19 卤0.15 卤0.10 卤0.12, respectively. There was no significant difference in visual acuity between the two groups (P0.05). For A-CNV, the specific visual acuity before and after treatment were 0.23 卤0.14g 0.13 卤0.100.18 卤0.09 卤0.19 卤0.110.03 卤0.03, respectively. The difference was statistically significant (P0.05) .PDT group could obtain the best visual acuity effect compared with other groups. Compared with the other groups, the treatment effect of PDT group was the worst, and the difference between two groups was statistically significant (P0.05). Conclusion IMP is a more economical and effective alternative for the treatment of CNV, especially in basic hospitals.
【作者单位】：河南科技大学第一附属医院眼科;解放军总医院眼科;
【基金】：全军“十一五”青年学者项目基金资助(编号:06Q068)~~
【分类号】：R774.5;R773.4

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