吲哚青绿血管造影引导多波长激光治疗年龄相关性黄斑变性脉络膜新生血管的临床评价

Effect of indocyanine green angiography inducted multi-wavelength laser on choroidal neovascularization in age-related macular degeneration

目的评价吲哚青绿血管造影（ICGA）引导多波长激光治疗年龄相关性黄斑变性（AMD）脉络膜新生血管（CNV）的临床疗效。方法对确诊为渗出型AMD伴有CNV患者19例24眼根据ICGA的结果，应用多波长氪离子激光对黄斑中心凹外200μm的CNV进行栅格状光凝封闭。治疗后2周、1个月、3个月、6个月进行视力、眼底、FFA、ICGA和黄斑区光敏感度（MLS）检查。结果治疗后随时间推移，多数患者视力逐步提高，6个月后视力提高13眼（54．17％），无变化9眼（37．50％），下降2眼（8．33％）。治疗2周～12个月后FFA和ICGA随访复查显示，22眼（91．67％）眼底渗出型病灶均不同程度吸收，渗出病灶缩小或形成瘢痕，色素沉着明显，强荧光减弱。治疗后患眼黄斑区光敏感度随时间推移逐渐提高，2周时7／13眼、1个月时10／13眼、3个月时8／9眼。结论ICGA引导多波长激光治疗AMD脉络膜新生血管定位准确、损伤小，安全有效。

Objective To evaluate the effects of indocyanine green angiography （ICGA） inducted multi-wavelength laser on choroidal neovascularization （CNV） in age-related macular degeneration（AMD）. Methods 24 eyes （19 patients） with exudative AMD with CNV were treated with multi-wavelength laser according to ICGA. After 2 weeks, 1 month, 3 months and 6 months followingup including vision, FFA, ICGA and macular light sensitivity （MLS）. Results After 6 months, vision was elevated gradually in 13/ 24 eyes, no changed in 9/24 eyes and fell off in 2/24 eyes. Absorption of focus was found in 22/24 eyes. Change included exudation absorption, cicatrization and pigmentation. MLS was advanced gradually in 7/13 eyes within 2 weeks, 10/13 eyes within 1 month and 8/9 eyes within 3 months. Conclusion Treatment of CNV in AMD with ICGA inducted multi-wavelength laser is exactituded, mini-traumaed, safe and effective.