经瞳孔温热疗法治疗黄斑部脉络膜新生血管的初步报告

A Primary Study of Transpupillary Thermotherapy for Choroidal Neovascularization at Macular Region

目的探讨经瞳孔温热疗法(Traspupillary Thermotherapy,TTT)治疗黄斑部脉络膜新生血管(Choroidal neovascularization,CNV)的临床效果.方法采用810nm半导体激光经瞳孔温热疗法治疗经眼底荧光血管造影(FFA)证实的黄斑部CNV患者19例20眼,治疗参数为光斑直径800～3000 μm,能量120～480 mW,曝光时间均为60 s,光凝数量1～4点.随访视力、中心视野及FFA,时间为2～8个月(平均4.90个月).结果视力改善6眼(占30.00%),视力稳定13眼(占65.00%),视力下降1眼(占5.00%).治疗后视力平均为0.12,与治疗前的平均视力0.09比较有改善,但差异无显著性(P>0.05).FFA显示治疗后CNV完全闭合者占20.00%,CNV较治疗前面积减小、渗漏减轻者占70.00%,CNV增大和渗漏增加者占10.00%.结论 TTT是一种安全有效的黄斑部CNV治疗方法,可使大部分患者视力稳定或提高.

Objective To investigate the clinical results of transpupillary thermotherapy for patients with choroidal neovascularization （CNV） at macular region, Methods Ninteen cases （20 eyes） of CNV at macular region diagnosed by FFA were treated with a diode laser at 810 nm, Laser parameters were as follow： the diameters of beam spot varied from 800μm to 3000μm, the power from 120mW to 480mW, the duration 600s, beam spots from 1 to 4. The visual acuity, central visual field and FFA were followed up. The follow-up period was 2-8 months（average 4,9 months. ） Results The visual acuity increased in 6 eyes（ 30.00% ） ; remained no change in 13 eye（65.00%） and decreased in 1 eyes（5.00% ）. The average visual acuity of 20 eyes was 0.12 at the last follow-up time compared with 0.09 in their first diagnosis. The difference was not significant （P 〉0.05 ）. FFA showed that after the treatment CNV complete closure in 20.00 % of eyes; partial closure and reduction of fluorescein leakage in 70.00 % of eyes, and CNV enlargement and increase of fluorescein leakage in 10.00% of eyes. Conclusions Transpupillary thermotherapy is one of the effective and secure therapies for CNV at macular region.