Changes in visual function after photodynamic therapy combined with intravitreal injection of Avastin for choroidal neovascularisation secondary to pathological myopia
SHI Yan-yun,LIANG Zhong-ying,YANG Ji-hong,ZHENG Dong-ping,SHEN Zhong-hua,ZHOU Guo-hong,PAN Lu-ping,DUAN Wei
Objective To observe the changes in visual function after photodynamic therapy （PDT） and PDT combined with an intravitreal injection of Avastin for macular choroidal neovascularization （CNV） secondary to pathological myopia （PM）. Methods Thirty-eight patients （38 eyes） with active CNV secondary to PM were included in a retrospective case series study. Twenty-one patients （21 eyes） were treated with PDT （PDT group）， while 17 patients （17 eyes） were treated with PDT combined with an intravitreal injection of Avastin （1.25 mg） （combination group）. All patients were assessed by an early treatment of diabetic retinopathy study （ETDRS） chart， optical coherence tomography （OCT） and MP-1 microperimetry before and 1， 3， and 6 months after treatment. Results were recorded and compared for the number of recognized letters， foveal nerve fiber layer thickness and macular median sensitivity （MS） within a central 20° area. Treatments were repeated if CNV leaked again. Data were analyzed using independent samples t test and paired t test. Results Six months after treatments， the numbers of recognized letters had increased， foveal retinal thickness had decreased and MS had increased in both the PDT group and combination group， and the differences were statistically significant （PDT group： t=-4.45， 10.72， -8.62， P<0.01； combination group： t=-9.28， 8.72， -11.54， P<0.01）. In the following month （7 months after treatment）， the differences in the number of recognized letters and foveal nerve fiber layer thickness were not statistically significant between the PDT group and combination group （P>0.05）， while the differences in MS were statistically significant （t=-2.86， -2.15， -2.50， P<0.05）. Conclusion PDT combined with an intravitreal injection of Avastin could effectively stabilize and improve the macular median sensitivity for CNV secondary to PM.
师燕芸,梁忠英,杨继红,郑东平,申仲华,周国宏,潘陆平,段薇. 光动力联合玻璃体腔注射Avastin治疗病理性近视脉络膜新生血管后视功能变化[J]. 中华眼视光学与视觉科学杂志, 2013, 15(3): 169-173.
SHI Yan-yun,LIANG Zhong-ying,YANG Ji-hong,ZHENG Dong-ping,SHEN Zhong-hua,ZHOU Guo-hong,PAN Lu-ping,DUAN Wei. Changes in visual function after photodynamic therapy combined with intravitreal injection of Avastin for choroidal neovascularisation secondary to pathological myopia. Chinese Journal of Optometry Ophthalmology and Visual Science, 2013, 15(3): 169-173. DOI: 10.3760/cma.j.issn.1674-845X.2013.03.010
Yoshida T， Ohno-Matsui K， Ohtake Y， et al． Long-term visual prognosis of choroidal neovascularization in high myopia： a comparison between age groups． Ophthalmology，2002，109：712-719．
[3]
You QS， Xu L， Yang H， et al． Five-year incidence of visual impairment and blindness in adult Chinese the Beijing Eye Study． Ophthalmology，2011，118：1069-1075．
[4]
Lam DS， Chan WM， Liu DT， et al． Photodynamic therapy with verteporfin for subfoveal choroidal neovascularisation of pathologic myopia in Chinese eyes： a prospective series of 1 and 2 year follow up． Br J Ophthalmol，2004，88：1315-1319．
[5]
Verteporfin in Photodynamic Therapy Study Group． Photodynamic therapy of subfoveal choroidal neovascularization in pathologic myopia with verteporfin： 1-year results of a randomized clinical trial—VIP report no. 1． Ophthalmology，2001，108：841-852．
[6]
ANCHOR Study Group． Ranibizumab versus verteporfin for neovascular age-related macular degeneration． N Engl J Med，2006，355：1432-1444．
[7]
Yoshida T， Ohno-Matsui K， Yasuzumi K， et al． Myopic choroidal neovascularization： a 10-year follow-up． Ophthalmology，2003， 110：1297-1305．
[8]
Shih YF， Ho TC， Hsiao CK， et al． Visual outcomes for high myopic patients with or without myopic maculopathy： a 10 year follow up study． Br J Ophthalmol，2006，90：546-550．
[9]
Hayashi K， Ohno-Matsui K， Shimada N， et al． Long-term results of photodynamic therapy for choroidal neovascularization in Japanese patients with pathologic myopia． Am J Ophthalmol，2011，151：137-147．
Pece A， Isola V． Retinal pigment epithelial marginal retraction after photodynamic therapy for choroidal neovascularization in pathologic myopia． Eur J Ophthalmol，2008，18：841-844．
[12]
Tatar O， Kaiserling E， Adam A， et al． Consequences of verteporfin photodynamic therapy on choroidal neovascular membranes． Arch Ophthalmol，2006，124：815-823．
[13]
Chan WM， Lai TY， Chan KP， et al． Changes in aqueous vascular endothelial growth factor and pigment epithelial-derived factor levels following intravitreal bevacizumab injections for choroidal neovascularization secondary to age-related macular degeneration or pathologic myopia． Retina，2008，28：1308-1313．
[14]
Yoon JU， Byun YJ， Koh HJ， et al． Intravitreal anti-VEGF versus photodynamic therapy with verteporfin for treatment of myopic choroidal neovascularization． Retina，2010，30：418-424．
[15]
Desco MC， Mataix J， Garcia-Pous M， et al． Combined therapy： photodynamic therapy and bevacizumab to treat myopic neovascular membranes． One-year follow-up． Retina，2011，31：475-481．
Yodoi Y， Tsujikawa A， Nakanishi H， et al． Central retinal sensitivity after intravitreal injection of bevacizumab for myopic choroidal neovascularization． Am J Ophthalmol，2009，147：816-824．
[19]
Scupola A， Tiberti AC， Sasso P， et al． Macular functional changes evaluated with MP-1 microperimetry after intravitreal bevacizumab for subfoveal myopic choroidal neovascularization：one-year results． Retina，2010，30：739-747．
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