经瞳孔温热疗法治疗中心性渗出性脉络膜视网膜病变的初步观察

Transpupillary thermotherapy in the treatment of central exudative chorioretinopathy

目的:探讨经瞳孔温热疗法(transpupillary thermotherapy,TTT)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。方法:对眼底荧光素血管造影(fundus fluorescein angiography,FFA)和吲哚青绿血管造影(indo cyanine green angiography,ICGA)检查确诊的CEC患者的18只患眼进行TTT治疗。采用810nm半导体激光,光斑0.8～2.0mm,照射时间60s,能量80～300mW,对FFA和ICGA图像所显示的脉络膜新生血管(choroidal neo vascularization,CNV)进行照射,照射区未出现颜色变化。对比分析患者治疗前后的视力、眼底、FFA结果。结果:治疗后视力提高者6眼,占33%;无变化者12眼,占67%。自觉症状有程度不同的改善者16眼,眼底检查病变减轻者10眼。13眼复查眼底血管造影,其中8眼脉络膜新生血管(choroidalneovascularization,CNV)明显消退、渗漏减轻。结论:TTT治疗CEC效果良好,值得临床推广应用。

AIM： To evaluate the effects of transpupillary thermotherapy （TTT） for the treatment of central exudative chorioretinopathy （CEC）. METHODS： Eighteen eyes of 18 cases suffered from CEC were treated with TTT delivered via diode laser at wavelength 810nm. A variable spot size of 0.8-2.0mm was used depending on the size of choroidal neovascularization （CNV）. The treatment was initiated in one spot for 60 seconds, duration at a power range between 200-350mW, and the treated area revealed no visible color. Preoperative and postoperative fluorescein angiography （FFA） was performed in 13 eyes. RESULTS： The visual acuity improved in 6 eyes （33%） and remained unchanged in 12 eyes （67%）. The symptom of self-knowledge was differently enhanced in 16 eyes. The pathological changes alleviated in 10 eyes in fundus examination. Fluorescein angiography （FFA） was performed in 13 eyes. CNV evidently vanished and exudation decreased in 8 eyes and 5 eyes remained unchanged in FFA. CONCLUSION： TTT is an effective method in treating CEC.