低能量TTT联合曲安奈德球后注射治疗中心性渗出性脉络膜视网膜病变  

Low power transpupillary thermotherapy with retrobulbar injection of triamcinolone acetonide for central exudative chorioretino-pathy

作　　者：徐建锋[1] 李贵洲[1] 叶瑞珍[1] 

机构地区：[1]解放军第180医院眼科医院,中国福建省泉州市362000

出　　处：《国际眼科杂志》2013年第8期1685-1687,共3页International Eye Science

基　　金：南京军区"十一五"医药卫生基金资助课题(No.08MA083)~~

摘　　要：目的: 探讨低能量经瞳孔温热疗法(transpupillary thermotherapy,TTT)联合曲安奈德(triamcinolone acetonide,TA)球后注射治疗中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy,CEC)的临床效果及安全性。方法: 对14例14眼CEC患者首先球后注射TA40mg/1mL+20g/L利多卡因0.5mL,然后于注射后1wk时再使用810nm半导体激光进行低能量TTT治疗(激光参数分别为:光斑直径0.8～3.0mm,照射时间60s,能量120～360mW),采用矫正视力、直接检眼镜、荧光素眼底血管造影(fundus fluorescein angiography,FFA)及光相干断层扫描(optical coherence tomography,OCT)来观察治疗后的效果及不良反应,随访3～12mo。结果: 治疗后视力提高者5眼(36%),无变化者8眼(57%),视力下降者1眼(7%)。12眼在治疗2wk后黄斑区出血、渗出明显减少,其中5眼在1mo后完全吸收,7眼在3mo后完全吸收,2眼眼底出现明显的黄斑瘢痕形成。治疗后3mo时,FFA检查发现CNV渗漏明显消退、减轻者7眼,无明显变化者5眼,2眼CNV扩大或渗漏增强;OCT检查发现12眼黄斑水肿均有不同程度改善,CNV强反射区域减小或者稳定,另2眼黄斑水肿加重、CNV扩大。结论: 低能量TTT联合TA球后注射对CEC有较好的治疗效果,临床上值得应用。·AIM： To observe the clinical effect of low power transpupillary thermotherapy （TTT） with retrobulbar injection of triamcinolone acetonide （TA） for central exudative chorioretinopathy （CEC）. ·METHODS： Fourteen eyes with idiopathic choroidal neovascularization were treated with retrobulbar injection of TA and performed by low power TTT after one week. Laser parameters were as follows： spot diameter 0. 8- 3.0mm, low power 120-360mW, time 60 seconds. By 3 to 12 months of follow- up, visual acuity, ophthalmoscope, fundus fluorescein angiography （ FFA ） and optical coherence tomography （OCT） were used to observe the curative effects. · RESULTS： Visual acuity were improved in 5 eyes （36%）, remained stable in 8 eyes （57%） and declined in 1 eye （7%） after treatment. The macular hemorrhage and exudation were reduced significantly in 12 eyes. FFA showed that the fluorescein leakage ceased or decreased in 7 eyes, unchanged in 5 eyes, and enlarged in 2 eyes. The macular edema of 12 eyes in OCT was reduced unequally.· CONCLUSION： Low power TTT combined withretrobulbar injection of TA shows good therapeutic effect on CEC.

关 键 词：经瞳孔温热疗法 低能量 曲安奈德 中心性渗出性脉络膜视网膜病变 

分 类 号：R774.1[医药卫生—眼科]