摘要
目的:探讨联合泛格栅光凝、光动力疗法(photodynamictherapy,PDT)、抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物对大范围湿性年龄相关性黄斑变性(age-related mac u lard egen erat i o n,A M D)的临床疗效,探索对视力较差的湿性A M D的更经济的治疗手段。方法:将病灶范围≥1.5 DD、视力<0.3的AMD患者分为试验组与对照组。试验组采用联合治疗,即先采用泛格栅光凝对一个大的脉络膜新生血管(choroidal neovascularization,CNV)病变或多个CNV病变的黄斑中心拱环外区域进行直接光凝,再对黄斑中心病变采用PDT治疗,最后在PDT治疗后2～3 d采用玻璃体腔注射抗VEGF药物。对照组(VEGF组)采用标准的3+prn抗VEGF药物注射治疗。评价治疗前后视力的变化情况、重复治疗次数等。结果:试验组27例,治疗次数(1.2±0.47)次;对照组37例,治疗次数(3.4±1.9)次,两组间治疗次数有显著差异,但两组治疗后视力比较无显著差异。结论:采用综合治疗方法,在大大减少治疗次数的前提下,能较好地保存患者的残存视力,具有较大的推广意义。
Objective:To evaluate the clinical efficacy of the combination of pan-macular grid laser,photodynamic therapy(PDT)and anti-vascular endothelial growth factor(VEGF)on a wide range of wet age-related macular degeneration(AMD),and to explore a more economical treatment method for wet AMD with low visual acuity.Methods:Patients with AMD with a range of lesions greater than 1.5 DD and visual acuity less than 0.3 were divided into the experimental group and the control group.In the experimental group,combined treatment was adopted,namely,a large choroidal neovascularization(CNV)lesion or multiple CNV lesions were treated by means of pan-macular grid laser directly in the outer area of the macular central arch,followed by the treatment of macular central lesions by PDT,and finally two to three days after the treatment of PDT,anti-VEGF drugs were injected into the vitreous cavity.In the control group(VEGF group),a standard 3+prn anti-VEGF medication was administered.The changes in the visual acuity before and after the treatment were evaluated.Results:There were 27 cases in the experimental group,receiving(1.2±0.47)times of treatment on average,and 37 cases in the control received(3.4±1.9)times of treatment on average.Conclusion:The combined treatment can save the patient’s remaining vision and deserves widespread application,on the premise of significantly reducing the number of treatment.
作者
张译心
刘晓萃
黄厚斌
ZHANG Yixin;LIU Xiaocui;HUANG Houbin(Department of Ophthalmology,Hainan Branch of Chinese PLA General Hospital,Sanya Hainan 572013;Department of Ophthalmology,General Hospital of Chinese PLA,Beijing 100853,China)
出处
《眼科学报》
2018年第4期252-259,共8页
Eye Science
基金
解放军总医院临床科研扶持基金(2012FC-TSYS-3046)~~
关键词
年龄相关性黄斑变性
泛格栅光凝
光动力疗法
血管内皮生长因子
age-related macular degeneration
pan-macular grid laser
photodynamic therapy
vascular endothelial growth factor
