Η σημασία των χοριοαμφιβληστροειδικών αγγειακών αναστωμόσεων στην αντιμετώπιση της χοριοειδικής νεοαγγείωσης της ωχράς κηλίδας με την φωτοδυναμική θεραπεία

Abstract

TAP and VIP study showed that photodynamic therapy (PDT) is beneficial against predominantly classic and occult with no classic choroidal neovascularization (CNV). However, in this study, there was no separated analysis between the results concerning eyes with CNV associated with retinal choroidal anastomoses (RCA) or pigment epithelium detachment (PED). In our study fourty two patients (44 eyes) with retinal choroidal anastomoses were treated with PDT. The results were compared with those of a control group which included 100 patients (101 eyes) without RCA treated also with PDT. In the vast majority of cases (88.7%) visual acuity decreased three or more Snellen lines presenting a statistically significant difference from the control group (46.5%). The lesion’s size increased in 90.9%, showing also a statistically significant difference (50.5%) if compared to the control group. Finally, five eyes (13.8%) developed retinal pigment epithelium detachment after the PDT, a complication that was not observed among the eyes of the control group. The functional and anatomical outcomes of our study showed that the presence of retinal choroidal anastomoses in eyes with CNV due to AMD carries a bad prognosis. For this reason, we consider that among the eyes with predominantly classic or occult CNV, the distinction between these associated with RCA and those without this communication is essential, as they do not respond similarly to the PDT treatment.

Η εφαρμογή φωτοδυναμικής αγωγής σε χοριοειδική νεοαγγείωση της ωχράς σε ηλικιακή εκφύλιση της ωχράς δεν συνοδεύεται από ευνοϊκά λειτουργικά και αναστομωτικά αποτελέσματα όταν συνυπάρχουν χοριοαμφιβληστροειδικές αγγειακές αναστομώσεις. Επίσης η παρουσία αποκόλλησης του μελάγχρου επιθηλίου συνοδεύεται από αυξημένο ποσοστό εμφάνισης των επικοινωνιών αυτών.