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要約 目的:光線力学療法を行ったポリープ状脈絡膜血管症と行わなかった症例の経過報告。対象:ポリープ状脈絡膜血管症56例56眼を対象とした。25眼は光線力学療法が可能になる前の症例で「非治療群」とし,39眼には光線力学療法を行って「治療群」とした(重複あり)。結果:非治療群の視力は,12か月後に21%,24か月後に54%で悪化した。眼底所見は,12か月後に26%,24か月後に59%で悪化し,その悪化因子は男性であり,病変が中心窩下にあることであった。治療群の視力は,12か月後に21%,24か月後に52%で悪化した。眼底所見は,12か月後に47%,24か月後に80%で悪化した。視力の悪化因子は多発性ポリープ状病巣であることで,単発病巣よりもハザード比が3.6倍であった。結論:ポリープ状脈絡膜血管症での視力と眼底所見は2年以上の経過中に半数以上で悪化し,性別,病変部位,病像が予後と関連する可能性がある。
Abstract. Purpose:To report the clinical course of polypoidal choroidal vasculopathy with or without treatment by photodynamic therapy(PDT). Cases and Method:This retrospective study was made on 56 eyes of 56 patients of polypoidal choroidal vasculopathy. Twenty-five eyes were seen before PDT became available. Thirty-nine eyes received PDT. Eight eyes before PDT were encluded in the non-PDT group. Results:Visual acuity in non-PDT group deteriorated in 21% of eyes after 12 months and in 54% after 24 months. Fundus findings deteriorated in 26% after 12 months and in 59% after 24 months. Factors for deterioration were male and presence of lesion in the subfovea. In PDT-treated group, visual acuity deteriorated in 21% after 12 months and in 52% after 24 months. Fundus findings deteriorated in 47% of eyes after 12 months and in 80% after 24 months. Visual acuity deteriorated 3.6 times more in eyes with multifocal polypoidal lesion than without. Conclusion:Visual acuity and fundus findings deteriorated in more than 50% of eyes with polypoidal choroidal vasculopathy. The deterioration was associated with male gender, location of lesion and multifocal lesions.
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