【摘要】：目的探討吲哚青綠介導(dǎo)的光栓塞(indocyanine green-mediated photothrombosis,IMP)治療黃斑中心凹下脈絡(luò)膜新生血管(choroidal neovascularization,CNV)的療效。方法選擇特發(fā)性CNV(idiopathic CNV,I-CNV)和年齡相關(guān)性黃斑變性(age-related macular degeneration,AMD)伴黃斑中心凹下CNV(AMD with subfoveal CNV,A-CNV)患者共360例(432眼),分成光動(dòng)力療法(photodynamic therapy,PDT)治療組(PDT組)、經(jīng)瞳孔溫?zé)岑煼?transpupillary thermotherapy,TTT)組、IMP組、IMP+玻璃體內(nèi)注射曲安奈德(intravitreal triamcinolone acetonide,IVTA)組及對(duì)照組。通過眼底照相、光學(xué)相干斷層掃描、熒光素眼底血管造影、吲哚青綠血管造影等檢查觀察CNV的消退情況,觀察視力的變化,比較各種治療效果。結(jié)果各組A-CNV患者治療次數(shù)差異有統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)于ICNV,PDT組、TTT組、IMP組、IMP+IVTA組、對(duì)照組治療前后具體的視力變化分別為0.13±0.11、0.09±0.12、0.12±0.14、0.19±0.15、0.10±0.12,各組之間視力差異無統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)于A-CNV,各組治療前后具體的視力變化分別為0.23±0.14、0.13±0.10、0.18±0.09、0.19±0.11、0.03±0.03,各組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。PDT治療組較其余各組可獲得最好的視力效果;IMP聯(lián)合或不聯(lián)合IVTA的療效其次,不如PDT組;TTT治療組與其余各組比較,治療效果最差;組間兩兩比較差異均有統(tǒng)計(jì)學(xué)意義(均為P0.05)。結(jié)論 IMP是一種治療CNV的更為經(jīng)濟(jì)有效的替代方法,適合推廣應(yīng)用,特別是在基層醫(yī)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 鹵0.110.09 鹵0.12 鹵0.12 鹵0.14 鹵0.19 鹵0.15 鹵0.10 鹵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 鹵0.14g 0.13 鹵0.100.18 鹵0.09 鹵0.19 鹵0.110.03 鹵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.
【作者單位】： 河南科技大學(xué)第一附屬醫(yī)院眼科;解放軍總醫(yī)院眼科;
【基金】：全軍“十一五”青年學(xué)者項(xiàng)目基金資助(編號(hào):06Q068)~~
【分類號(hào)】：R774.5;R773.4

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