The Clinical Researches Of Photodynamic Therapy Combined With Chinese Medicine For Choroidal Neovascularization

Background and objection:Maculopathy caused by choroidal neovascularization (CNV) is a group ofdiseases diffcult to treat at present. Hemorrhage, exudation, retinal pigmentepithelium detachment and neurosensory retinal detachment caused by CNV andscar formation at last were the main cause of blindness in CNV diseasesincluding age-related macular degeneration (AMD). Recently, photodynamictherapy (PDT) provided us with a new means to treat this kind of diseases andhas been used in clinic. It is considered that the mechanism of PDT used fortreatment of CNV was that the photosensitizer which injected in the body wasspecially combined with neovascular endothelial cells and more stagnated inthe lumens of CNV. The photochemical reaction occurred after exposure in adefinite wave length laser. The endothelial cells of CNV were then damagedand the lumens of CNV were blocked. The leakage of blood constituent stoppedor decreased and the more damage of photoreceptor cells by CNV wascontrolled. But PDT can not exterminate the recur of the CNV, and it also hasthe defects like the inthorough treatment of the CNV. But CNV in some peoplerecurrent in a very short period. The long-term efficacy of PDT for CNV is aboutto observing further.Maculopathy is related to spleen closely in traditional chinese medicine.Deficiency of spleen-Qi and its dysfunction of transformation andtransportation are the pathology foundation of maculopaty. Water,bloodstasis and phlegm are the pathology changes. Therefore invigorating spleen-Qi is the rule of treating Ben, while removing blood stasis,resolving phlegmand so on are of Biao. We have used the jianpihuazhuofang to treat age-relatedmacular degeneration, and had a very nice clinic outcome.The objective of our study is to explore the clinical effect of treatingmaculopathy caused by choroidal neovascularization(CNV) by PDT combined withjianpihuazhuofang.Methods:Do the clinical observation by using PDT combined withjianpihuazhuofang as treating group and comparing control group with pure PDT.Thirty-three cases(34 eyes) diagnosed as maculopathy patients with CNV weretreated with PDT.The data of visual acuity testing, fluoresceinannionraphy(FFA) and optic coherence tomonraphy (OCT) were used to evaluatethe effects of the treatment of PDT combined with jianpihuazhuofang beforeand 1,3 month after treatment. 18 cases(18 eyes) in the group of PDT intervenedby jianpihuazhuofang, and 15 cases(16 eyes) in the control group.Result:In 1,3 months after the treatment, there were no statisticallysignificant between two groups in BCVA. There were statistically significantdifferences between two groups in greatest linear dimension (GLD) (P＜0.05).Thethicknesses of macular retina(P＜0.05) and CNV complex (P＜0.05) decreasedsignificantly compaired with the PDT group.Conclution:PDT intervened by jianpihuazhuofang can promote the absorbtion ofthe blood stasis and fluid leakage, stimulate the shrinkness of CNV, stabilizethe role of PDT and reduce the reacurrunt of CNV.