Abstract:AIM: To observe and compare the changes of macular retinal thickness in patients with pathologic myopia complicated with choroidal neovascularization(CNV)after anti-vascular endothelial growth factor(VEGF)therapy or photodynamic therapy(PDT)alone, and to explore an effective treatment method for CNV.
METHODS: The clinical data of 43 pathologic myopia patients(45 eyes)complicated with CNV treated in our hospital from November 1, 2014 to June 30, 2015 were retrospectively analyzed and their curative effect of different treatment methods were compared through the analysis. In them, 20 patients(22 eyes)treated with anti-VEGF alone were set as the observation group and 23 patients(23 eyes)treated with PDT were set as the control group. The visual acuity of the two groups after 6mo of treatment was compared, and OCT examination was performed to compare their macular retinal thickness, CNV strong reflection of regional changes and subretinal fluid absorption. The fluorescein angiography(FFA)and indocyanine green angiography(ICGA)were used to compare the CNV leakage and the adverse reactions between the two groups. The width, height, distance from the fovea and the incidence of adverse reactions of the CNV breakthrough retinal pigment epithelium(RPE)before and after treatment were compared between the two groups.
RESULTS: The eye ratio of the visual acuity in the observation group increased by two lines was 82%, which was significantly higher than 74% of the control group, and the difference was statistically significant(P<0.05); OCT showed no significant difference in retinal thickness before treatment between the two groups(P>0.05), but after the treatment, the retinal thickness was significantly lower in the observation group than in the control group(P<0.05). The FFA and ICGA examination showed that the proportion of CNV in the observation group was 86%, and the leakage was reduced by 14%, which was significantly different from that in the control group(74%, 22%), and the difference was statistically significant(P<0.05). The incidence of adverse reactions in the observation group was 14% and 17% in the control group, there was no significant difference between two groups(P>0.05). After treatment, the width, height and distance from the fovea of the CNV breakthrough RPE of both groups decreased, and the observation group was significantly lower than that of the control group(P<0.05).
CONCLUSION: Compared with PDT treatment, anti-VEGF treatment alone can significantly improve the visual acuity of patients with pathologic myopia complicated with CNV, reduce macular retinal thickness with a better effect of stopping leakage.