摘要目的 观察息肉样脉络膜血管病变(PCV)患眼光动力疗法(PDT)治疗前后的光相干断层扫描(OCT)图像特征,探讨其与视力的关系.方法 经荧光素眼底血管造影、吲哚青绿血管造影检查确诊为PCV的34例患者40只眼纳入研究.所有患者确诊后接受PDT治疗.治疗前后均行最小分辨角对数(logMAR)矫正视力及频域OCT检查.测量视网膜色素上皮脱离(PED)高度和基底宽度、视网膜脱离(RD)高度和基底宽度、黄斑中心区厚度(CST)及6 mm直径范围内黄斑容积(MV).治疗前患眼平均logMAR矫正视力0.66±0.32;OCT检查均可见明显PED及神经上皮脱离.对比观察分析治疗前及治疗后1、3、6、12个月OCT检测指标的变化情况及其与视力变化的相关性.结果 治疗后1、3、6、12个月,患眼平均logMAR矫正视力分别为0.58±0.27、0.48±0.38、0.51±0.37、0.50±0.36.治疗前后视力比较,治疗后1、6个月与治疗前差异均无统计学意义(t=1.22、1.96,P＞0.05);治疗后3、12个月与治疗前差异均有统计学意义(t=2.32、2.10,P＜0.05).治疗后1、3个月PED高度(t=1.07、1.50)和基底宽度(t＝1.39、1.57)与治疗前比较,差异均无统计学意义(P＞0.05);治疗后6、12个月PED高度(t=2.34、2.03)和基底宽度(t=2.08、2.00)与治疗前比较,差异均有统计学意义(P＜0.05).治疗前与治疗后1、3、6、12个月RD高度(t＝2.22、2.99、3.30、3.95)和基底宽度(t=2.55、3.33、3.11,3.92)比较,差异均有统计学意义(P＜0.05).治疗前与治疗后1,3,6,12个月CST (t=2.71、3.55、3.81、3.21)和MV(t=2.10、3.30、3.62、4.18)比较,差异均有统计学意义(P＜0.05).相关性分析结果显示,PCV患眼视力与PED基底宽度、RD高度和基底宽度、CST及MV均呈负相关(r=-0.88、-0.89、-0.92、-0.86、-0.94,P＜0.05);与PED高度无相关性(r=-0.70,P＞0.05).结论 PDT治疗后PCV患眼PED高度和基底宽度、RD高度和基底宽度、CST和MV均较治疗前降低.PCV患眼视力与PED基底宽度、RD高度和基底宽度、CST、MV呈负相关.

abstractsObjective To observe the characteristics of optical coherence tomography (OCT)in polypoidal choroidal vasculopathy (PCV) before and after photodynamic therapy (PDT),and investigate its relationship with visual acuity.Methods Thirty-four PCV patients (40 eyes) diagnosed by fundus fluoresce angiography and indocyanine green angiography who had underwent the treatment of PDT,were enrolled in this study.The logMAR corrected visual acuity (CVA) were detected and the height and the base diameter of retinal pigment epithelium detachment (PED)and retinal detachment (RD),central subfield thickness (CST),macular volume (MV) were measured by OCT before and after treatment.Before the treatment,the mean logMAR CVA was 0.66 0.32 and visible PED and RD were seen on OCT images.The OCT characteristics and relationship with visual acuity were comparatively analyzed.Results One,three,six and 12 months after treatment,the mean logMAR CVA were 0.58 0.27,0.48 0.38,0.51 0.37 and 0.50 0.36.The differences of CVA were statistically significant between before-treatment and three,12 months after treatment(t=2.32,2.10; P＜0.05),but not between before-treatment and one,six months after treatment (t=1.22,1.961 P＞0.05).The differences of the height and the base diameter of PED were statistically significant between before-treatment and six,12 months after treatment (t＝2.34,2.03; P＜0.05),but not between before-treatment and one,three months after treatment (t =1.07,1.50; P ＞ 0.05).The differences of the height (t=2.22,2.99,3.30,3.95) and the base diameter (t=2.55,3.33,3.11,3.92)of RD were statistically significant between before-treatment and one,three,six and 12 months after treatment (P＜0.05).The differences of CST (t=2.71,3.55,3.81,3.21) and MV (t=2.10,3.30,3.62,4.18) were statistically significant between before-treatment and one,three,six and 12 months after treatment (P＜0.05).CVA had negative correlation with the base diameter of PED,the height and the base diameter of RD,CST and MV (r=-0.88,-0.89,-0.92,-0.86,-0.94; P＜0.05),no correlation with the height of PED (r=-0.70,P＞0.05).Conclusions The height and the base diameter of PED and RD,CST,MV of PCV are decrease after PDT.There is a negative correlation between CVA and the base diameter of PED,the height and the base diameter of RD,CST and MV.