光动力联合TA后Tenon囊下注射治疗多灶性脉络膜炎合并CNV疗效观察
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Therapeutic effect of photodynamic therapy and injection of triamcinolone acetonide via posterior sub-tenon combination therapy on choroidal neovascularization combined with multifocal choroiditis
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    目的:评价光动力疗法(photodynamic therapy,PDT)联合曲安奈德(triamcinolone acetonide,TA)后Tenon囊下注射,治疗多灶性脉络膜炎(multifocal choroiditis,MC)合并脉络膜新生血管(choroidal neovascularization,CNV)的临床疗效。方法:回顾性分析8例8眼临床确诊为MC合并CNV患者的临床资料,对比分析PDT联合TA后Tenon囊下注射治疗前后患者最佳矫正视力(BCVA),FFA/ICGA和OCT等检查结果的变化。结果:联合治疗后随访6mo,所有患者BCVA与治疗前相比均明显提高,差异具有统计学意义(P<0.05)。FFA/ICGA检查显示,联合治疗后1moMC前节及眼底活动性炎症减退或停止者8眼(100%),CNV病灶渗漏停止或渗漏减少者7眼(88%)持续渗漏1眼(12%)。PDT治疗后6mo,MC炎症未发现复发,CNV病灶渗漏停止或渗漏减少者8眼(100%)。OCT显示CNV缩小,组织水肿减轻。结论:PDT联合TA后Tenon囊下注射治疗多灶性脉络膜炎合并脉络膜新生血管安全有效。

    Abstract:

    ·AIM:To investigate the efficacy of photodynamic therapy(PDT)and injection of triamcinolone acetonide(TA)via posterior sub-tenon combination therapy on choroidal neovascularization(CNV)combined with multifocal choroiditis(MC).·METHODS:Eight patients(8 eyes)who were diagnosed as MC combined with CNV were retrospectively analyzed.The changes in the best-corrected visual acuity(BCVA),FFA/ICGA and OCT were analyzed before and after combination therapy.·RESULTS:During 6-month follow-up the BCVA was improved after combination therapy(P<0.05).FFA/ICGA showed decrease and stoppage of inflammation on preocular and fundus in 8 eyes(100%),no leakage or reduced leakage in 7 eyes(88%)1 month after combina-tion therapy.In 1 eye(12%),the fundus remained leaky.At the 6-month follow-up,no inflammation relapse was obtained,FFA /ICGA showed no leakage or slight leakage in 8 eyes(100%).·CONCLUSION:Combination therapy of PDT and injec-tion of TA via posterior sub-tenon is safe and effective to CNV combined with MC.·

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殷海泉,徐丽,殷亮.光动力联合TA后Tenon囊下注射治疗多灶性脉络膜炎合并CNV疗效观察.国际眼科杂志, 2010,10(5):968-970.

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