Objective To compare the clinical results of photodynamic therapy(PDT) and transpupillary thermotherapy (TTT) for patients with choroidal neovascu larization caused by exudative age-related macular degeneration. Methods Seventy cases (82 eyes) with exudative AMD were divided into PDT and TTT groups. Thirty-five cases (42 eyes) were treated with PDT. Nineteen eyes had occult or predominantly occult CNV. Twenty-three eyes had classic or predominantly classic CNV. Thirty-five cases (40 eyes) were treated with TTT. Twenty-five eyes had occult or predominantly occult CNV. Fifteen eyes had classic or predominantly classic CNV . Visual acuity, FFA, ICGA and OCT were evaluated before and after treatment. All cases were subfoveal or juxtafoveal CNV. The follow-up was 3-6 months. Results Visual acuity in 3 eyes (15.8％) of PDT group and 1 eye (4.0％) in TTT group increased at least 2 lines. The difference was no significant(P=0.1778), FFA showed cessation or reduction of fluorescein leakage from CNV in 15 eyes(78.9％) in PDT group and 13 eyes(52.0％) in TTT group. The difference was not significant (P=0 .0657). Three months after treatment, The visual acuity of 2 eyes(10.5％) in PDT group and 2 eyes (8.0％) in TTT group increased at least 2 lines. The difference was not significant (P=0.7728). FFA showed cessation or reduction of fluorescein leakage from CNV in 8 eyes(42.1％) in PDT group and 21 eyes(84.0％) in TTT group. The difference was significant (P=0.0037). Conclusion For classic CNV, the short-term effect of PDT is better than TTT concerning visual acuity. The effect of PDT is apparently better than TTT in cessation or reduction of fluorescein leakage one month after treatment. But there was no significant difference between PDT and TTT in cessation or reduction of fluorescein leakage three month after treatment. For occult CNV, there is no significant short-term difference between PDT and TTT concerning visual acuity. There was no significant difference between PDT and TTT in cessatin or reduction of fluorescein leakage one month after treatment. But three month after treatment TTT is apparently better than PDT in cessation or reduction of fluorescein leakage. We need more cases and longer follow-up to evaluate these two kinds of treatments in treating exudative age-related macular degeneration.(Chin J Ocul Fundus Dis，2004，20：285-288)
Objective To investigate the related factors of effects on distant visual acuity after photodynamic therapy (PDT) for choroidal neovascularization (CNV). Methods One hundred and thirty-five cases (135 eyes ) of CNV treated with PDT were observed. The gender, preoperative distant and near visual acuity, disease course, pathogeny, area of CNV, types of CNV ascertained by fundus fluorescein angiography (FFA), and changes of CNV in FFA were recorded. Multi-factor regression analysis of visual acuity within 1 month and 3 months after PDT was performed with SPSS statistics software. Results The distant visual acuity within 1 month postoperatively was related to the preoperative distant visual acuity, the area of CNV and the changes in the FFA（P=0.000,0.030,0.062）, and 3 months after PDT, it was related to the distant and near visual acuity preoperatively and the changes in the FFA（P=0.000,0.054,0.034）. The condition of distant visual acuity within 1 month postoperatively was related to the FFA type of CNV and the disease course（P=0.018,0.08）. Conclusion The smaller the area of CNV is, the better postoperative distant visual acuity would be. The proportion of improvement of visual acuity is relatively higher in patients with classic CNV. Early treatment for the patients with the indicatio may improve the visual acuity effectively. (Chin J Ocul Fundus Dis，2004，20：292-294)
Objective To evaluate safty and effects of a single photodynamic therapy(PDT) for circumscribed choroid hemangiomas. Methods We performed a retrospective analysis of 11 eyes of 10 patients who were reated with single standard PDT. Of 10 patients, 6 males, 4 females；mean 40 .2 years old；of 11 eyes, 6 left eyes, 5 right eyes; 1 patient who both eyes wer e involved. Follow-up time varied from 1month to 14months, mean 6.2 month. Results After treatment, all tumors show various degrees of regression and subretinal fluid were absorbed completely or partly. The visual acuity of 8 eyes improved; that of 3 eyes unchanged. Conclusions PDT is effective modality for circumscribed choroid hemangiomas. (Chin J Ocul Fundus Dis,2008,24:111-113)
Objective To investigate the impact of photodynamic therapy (PDT) with verteporfin on the expression of pigment epithelial derivative factor (PEDF) mRNA and vascular endothelial growth factor (VEGF) mRNA in adult retinal pigment epithelial (RPE) cells in vitro. Methods The changes of cellular viability before and after PDT were assessed by methyl thiazolyl tetrazolum (MTT) colorimetric assay. Semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) was conducted to detect the expression of PEDF and VEGF mRNA in RPE cells before and after PDT. Results PDT caused the death of RPE cells. The cellular mortality was positively correlated with the power of photocoagulation and the concentration of verteporfin. Conclusion PDT could downregulate the expression of PEDF and VEGF mRNA in adult RPE cells in vitro, which may relate to the cure or relapse of subfoveal choroidal neovascular membrane after PDT. (Chin J Ocul Fundus Dis, 2006, 22: 256-260)
Objective To detect the apoptosis of vascular endothelial cells and retinal pigment epithelial (RPE) cells in vitro induced by verteporfin-photodynamic therapy. Methods Cultured vascular endothelial cells and human RPE cells were incubated with verteporfin at a concentration of 1.0 mu;g/ml which was equivalent to the initial plasma level of verteporfin in clinical therapy. Each kind of cells were divided into 6 groups according to different time of incubation: 0, 5, 15, 30, 60, and 120 minutes group. After incubated, the cells were illuminated by the laser light with the maximum wavelength of absorption of verteporfin (wavelength: 689 nm, power density: 600 mW/cm2) with the power of 2.4 J/cm 2for 83 seconds. The percentage of cellular apoptosis was measured by flow cytometry 3 hours after PDT, and the measurement was repeated thrice. Results The proportion of cellular apoptosis 3 hours after PDT were 0.01plusmn;0.01, 0.25plusmn;0.02, 0.32plusmn;0.02, 0.41plusmn;0.04, 0.49plusmn;0.03 and 0.61plusmn;0.02, respectively in 0-120 minutes group of vascular endothelial cells; and 0.02plusmn;0.01, 0.22plusmn;0.01, 0.31plusmn;0.02, 0.38plusmn;0.03, 0.47plusmn;0.05 and 0.58plusmn;0.03 respectively in 0-120 minutes group of RPE cells. The proportion of cellular apoptosis of both kinds of the cells increased as the incubation time was prolonged. There was no significant difference of the percentage of cellular apoptosis between the accordant time groups in the two kinds of cells (P＞0.05). Conclusions Cellular apoptosis can be quickly induced by verteporfin-PDT both in human vascular endothelial cells and RPE cells; under the same condition in vitro, PDT has no obvious selection for the apoptosis of the two kinds of cells. (Chin J Ocul Fundus Dis, 2006, 22: 253-255)