经瞳温热疗法治疗湿性年龄相关黄斑变性的疗效观察  

Transpupillary thermotherapy of choroidal neovascularization in patients with age-related macular degeneration

作　　者：周咏东[1] 周天球[1] 范红娟[1] 

机构地区：[1]南通大学第二附属医院眼科,中国江苏省南通市226001

出　　处：《国际眼科杂志》2005年第5期961-963,共3页International Eye Science

基　　金：中国江苏省南通市科技局资助项目(No.S2004)

摘　　要：目的:探讨经瞳温热疗法(tran spupillarty thermother-apy,TTT)治疗湿性年龄相关黄斑变性(age-related macular degeneratio,nARMD)的初步疗效。方法:对9例14眼经眼底检查、荧光素眼底血管造影(fundus fluorescein angiography,FFA)和吲哚菁绿眼底血管造影(indocyanine greenangiography,ICGA)确诊为湿性ARMD(12眼为隐匿型、2眼为经典型)的患眼行TTT治疗。根据脉络膜新生血管膜(choroidal neovascular membrane,CNV)的范围选择不同的光斑大小和能量,术后对眼底改变、视力、眼底血管造影复查,随访1～22(平均11.67)mo,以观察疗效。结果:经TTT治疗后,至末次复查时11眼(79%)出血、水肿、渗出消失、病灶斑痕化,3眼(21%)的出血、水肿、渗出明显减轻。5位患者的8眼患眼有TTT后的FFA及ICGA复查,显示其中6眼的原病灶渗漏消失、CNV消退,2眼的渗漏明显减轻。治疗后视力提高的有4眼(29%),稳定的有7眼(50%),下降的有3眼(21%)。除2位患者的2只患眼(14%)分别在第一次治疗后的第4和第5mo经造影复查后,接受了原病灶的再次TTT外,其余患眼(86%)均只进行了一次TTT。结论:TTT对湿性ARMD有较明确的疗效,经济安全,其远期疗效需更多病例观察。AIM： To evaluate the clinical effect of transpupillary therrnotherapy （TTT） on choroidal neovascularization （CNV） in patients with age-related macular degeneration （ARMD）. METHODS： The clinical data of 14 eyes of 9 ARMD patients with CNV treated with ITT were retrospectively analyzed. Spot sizes applied depended on the sizes of the CNV and energy between 200 and 750roW with a beam diameter from 0.5 to 4.0ram, with 60 seconds of exposure time. The visual acuity, complications, fundus image and FFA/ICGA were observed preand postoperatively in the treated eyes. The average period of follow-up was 11.67mo （1-22mo）. RESULTS： The retinal hemorrhage and leakage of CNV were completely absorbed after TTT in 11 eyes （79%） and ameliorated in 3 eyes （21%）. The visual acuity showed improved in 4 eyes （29%）,maintained in 7 eyes （50%） and decreased in 3 eyes（21%）. There were two eyes received second TTT after 4-5mo. CONCLUSION： TTT is an effective and safe treatment for CNV caused by ARMD. The long-term effect needs more clinic observations.

关 键 词：经瞳温热疗法 年龄相关黄斑变性 脉络膜新生血管膜 年龄相关黄斑变性 疗效观察 温热疗法 治疗后 荧光素眼底血管造影 湿性 吲哚菁绿眼底血管造影 脉络膜新生血管膜 green 

分 类 号：R774.5[医药卫生—眼科]