经瞳孔温热疗法治疗湿性年龄相关性黄斑变性的参数研究  

Power setting of transpupillary thermotherapy for patients with age-related macular degenera-tion

作　　者：周咏东[1] 范红娟[1] 周天球[1] 

机构地区：[1]南通大学第二附属医院眼科,南通226001

出　　处：《中国实用眼科杂志》2006年第9期976-978,共3页Chinese Journal of Practical Ophthalmology

基　　金：南通市科技局社会发展基金资助(编号:S2004)

摘　　要：目的评价三种不同参数的经瞳孔温热疗法(transpupillarythermotherapy,TTT)治疗湿性年龄相关性黄斑变性(age-relatedmaculardegeneration,ARMD)的疗效。方法2002年4月～2005年1月在我科确诊为ARMD渗出型患者24例32眼,男性17例25眼,女性7例7眼,年龄47～84岁(平均67.96岁)。其中17位患者(隐匿性CNV9眼、典型性及典型性为主型10眼)接受TTT治疗,按采取的能量参数分为100%能量组(7眼)、80%能量组(5眼)、70%能量组(7眼),其余7例13眼不接受任何治疗手段的患者作为无治疗组列为观察对象。术后对眼底改变、视力、眼底血管造影复查,随访6～37个月(平均21.65个月)观察疗效并进行统计分析。结果至末次复查时所有接受TTT治疗的19只患眼的出血、水肿、渗出消失、病灶斑痕化。100%能量组,80%能量组以及70%能量组视力提高的患眼比例相比较,均无统计学显著差异(分别为p=0.523,p=1.000,p=1.000)。治疗组(包括100%能量组,80%能量组以及70%能量组)与无治疗组视力下降的患眼比例相比较,有统计学显著差异(p=0.002)。治疗组与无治疗组视力提高的患眼比例相比较,无统计学显著差异(p=0.361)。结论TTT对隐匿型和经典型CNV均有稳定患眼视力的作用。目前选择该研究中80%能量组的参数,可以在安全性和有效性上得到进一步完善,仍有待更多病例的证实。Objective To evaluate the clinical effect of transpupillary thermotherapy（TTT） with three different power settings. Methods Four groups were followed up 6-37 months（average 21.65 months）. They are 100% power group（7 eyes）, 80% power group（5 eyes）,70% power group（7 eyes） and no treatment group（13 eyes）. The visual acuity, complications,fundus image and FFA/ICGA were observed pre- and postoperatively. Results The retinal hemorrhage and leakage of CNV were completely absorbed after TTT in all eyes.The ratio of improved visual acuity between 100% power group,80% power group and 70% power group showed no statistic significance（p=0.523, p=1.000, p=1.000）.However, The ratio of decreased but not improved visual acuity between TIT group（include 100% power group,80% power group and 70% power group） and no treatment group has statistic significance （p=0.002）. Conclusion TTT prevents the decrease of visual acuity in patients with occult and classic CNV caused by ARMD.The power setting of 80% power group seems more safe and effective.More cases and long term observation are needed.

关 键 词：经瞳孔温热疗法(TTT) 年龄相关性黄斑变性(ARMD) 剂量 

分 类 号：R774.5[医药卫生—眼科]