3 讨论
中心性渗出性脉络膜视网膜病变的自然病程进展比较缓慢,一般认为视力愈后好于老年黄斑变性患者,但患者个体差异很大,所以患者的自然愈后情况很难预料。国外大量文献报道该病多单眼发病,起病年龄32~38岁,多为孤立的CNV病灶,同时伴有出血[3,8]。本组患者中,年龄15~38(平均26)岁,与文献报道基本相符。因为该病患者年龄相比老年黄斑变性患者较年轻,所以很多医生不断尝试了很多治疗方法,例如黄斑下新生血管膜取出手术,黄斑转位手术等,目的在于帮助患者保护有用的视力,但都没有取得很好的疗效[3,4]。
激光光动力治疗(photodynamic therapy,PDT)被认为是一种安全有效的治疗方法,可以高选择性的物理封闭CNV,而不损伤其上正常的视网膜组织。自2000年PDT疗法问世以来,已经被证实在治疗年龄相关性黄斑变性和病理性近视诱发的CNV 有效。因为CEC诱发的CNV 以典型性CNV 为主,所以PDT 治疗应该是一种理想的选择。国内也不断有一些关于PDT治疗中渗的相关报道,其结果普遍较好[911]。我们观察的结果与文献报道相似。我们的研究还存在一些不足,比如病例数较少,随访时间比较短,不是随机对照研究。所以要评价PDT治疗对中渗的疗效和安全性,还需要大样本的随机对照实验加以证实。
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