经瞳孔温热疗法治疗黄斑部脉络膜新生血管  

Transpupillary Thennotherapy for Patients with Choroidal Neovascularization

作　　者：张勇进[1] 王文吉[1] 高巧云[1] 黎蕾[1] 罗传淇[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2003年第5期299-300,T002,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：国家教育部"留学归国人员科研启动基金"(1999)

摘　　要：目的探讨经瞳孔温热疗法(transpupillary thermotherapy,TTT)治疗黄斑部脉络膜新生血管膜(choroidal neovascularization,CNV)的疗效。方法经眼底荧光血管检查证实的各原因所致的黄斑部CNV患者27例30眼,其中老年黄斑变性9例11眼,高度近视12例12眼,中心性渗出性脉络膜视网膜炎(简称"中渗")5例5眼,血管条纹症1例,双眼。于2000年6月～2001年9月行TTT治疗,治疗采用IRIS半导体激光,波长810nm,光斑根据CNV病灶大小0.5～3.0mm,能量180～350mW,时间60s,治疗后病灶颜色不变或呈淡灰色。随访期8～24个月。结果视力提高2行以上者6眼,占20%,均为中渗或高度近视眼;21眼视力改变不超过2行,占70%;3眼视力下降2行,占10%。19眼于术后复查荧光血管造影,CNV有不同程度的减小或闭塞。结论TTT对多种原因所致的黄斑部CNV均有稳定作用,其作用可持续较长时间。治疗参数因患者眼底色素含量不同而有所差异。最终治疗效果与治疗前病程、CNV的位置及治疗参数的适度有关。Purpose To investigate the efficiency of transpupiEary themotherapy(TTT) for the treatment of patients with macular choroidal neovascularization (CNV) . Methods 30 eyes of 27 patients with macular CNV from various causes defined by fluorescein angiography were treated.TTT was delivered via diode laser at wavelength 810 nm with power settings 180-350 mW,60 seconds duration, and spot sizes in 0.5 - 3.0 mm with 1 or more spots according to the lesions. After treatment the lesions were in visible or a slight grey in color change. Outcome was assessed with visual acuity and clinical examination. Results The patients were followed up for 12-24 months. The vision improved more than two lines in 6 eyes (20%).In 21 eyes (70%),the vision changed less than two lines.Three eyes(10%) lost more than two lines in visual acuity. Conclusion TIT can stabilize the vision of the eyes of macular CNV from various causes. The parameters should be adjusted individually.

关 键 词：经瞳孔温热疗法 治疗 黄斑 脉络膜新生血管 

分 类 号：R774.5[医药卫生—眼科]