吲哚青绿介导的光栓疗法治疗限局性脉络膜血管瘤  

Indocyannine green mediated photothrombosis for circumscribed choroidal hemangioma

作　　者：张鹏[1] 王雨生[1] 王海燕[1] 胡丹[1] 贺竹宁[1] 白净[1] 张自峰[1] 苏晓娜[1] 白建伟[1] 

机构地区：[1]第四军医大学西京医院眼科全军眼科研究所,中国陕西省西安市710032

出　　处：《国际眼科杂志》2008年第8期1606-1608,共3页International Eye Science

摘　　要：目的：吲哚青绿（indocyannine green,ICG）的吸收峰（805nm）与810nm半导体激光波长相近,使其可成为治疗脉络膜血管瘤的光敏剂,该方法被称为吲哚青绿ICG介导的光栓疗法（indocyannine green mediated photothrombosis,IMP）。为了探讨IMP治疗脉络膜血管瘤的效果,我们对8例（8眼）限局性脉络膜血管瘤进行了治疗。方法：将2mL ICG溶液通过肘前静脉快速注射,使用IRIS810nm半导体激光器于注射后3min对瘤体进行照射。参数：光斑直径3.0～9.0mm,功率450～1300mW,照射时间60s。用同样参数于ICG注射后20min进行第二次激光照射。随访时间6～24mo（平均8.15mo）,通过视力、直接眼底镜、海德堡共焦眼底血管造影仪（heidelberg retina angio-graph,HRA）实施的眼底荧光素血管造影（fundus fluore-seein angiography,FFA）及吲哚青绿血管造影（indocyan-nine green angiograph,ICGA）观察治疗效果,用HeidelbergEye Explore软件测量治疗前后瘤体面积的变化。结果：至最后一次随访,经IMP治疗的8眼的血管瘤面积较治疗前均缩小（100%）,患眼矫正视力提高〉2行以上者有2眼（25%）,视力提高〉1行以上者有3眼（38%）,视力无变化者3眼（38%）。视力提高的5眼注视性暗影及视物变形等症状有程度不同的改善。结论：本研究结果显示,IMP对脉络膜血管瘤有一定治疗效果,该方法安全、经济。但有关IMP的治疗参数、远期疗效及并发症等问题还需更大样本的长期临床观察。AIM： To evaluate the efficacy of indocyannine green mediated photothrombosis （ IMP ） on choroidal hemangioma by treating 8 cases （ 8 eves ） with circumscribed choroidal hemangioma. METHODS： Tow milliliter ICG solution was injected through antecubital vein of patient, 3 minutes after injection, the IRIS 810nm semiconductor laser was used to irradiate the tumor. Beam spot diameter, power and duration were 3.0-9.0mm, 450-1300mW and 60 seconds. Twenty minutes after injection, the lesion was irradiated again with same parameters. The follow-up period was 6- 24 months （average 8.15 months）. Visual acuity, fundus examination, fundus fluorescein angiography （FFA） and indocyannine green angiograph （ICGA） executed by Heidelberg retina angiograph （HRA） were performed in all eyes before and after Heidelberg Eye Explore was change of tumor. treatment. The software used to measure the area RESULTS： After IMP, 8 eyes （100%） showed partial regression of the tumor. Respectively, corrected visual acuity of 2 eyes （25%） improved at lest 2 lines, 3 eyes （37. 5%） improved 1 line, 3 eyes （37. 5%） remained unchanged. CONCLUSION： IMP is effective, safe and economical to treat circumscribed hemangioma of choroid. But the parameters, long term outcomes and syndromes of IMP must be observed depending on large sample test of clinic.

关 键 词：激光 脉络膜新生物 血管瘤 

分 类 号：R739.7[医药卫生—肿瘤]