氩激光类经瞳孔温热疗法治疗黄斑脉络膜新生血管性病变疗效观察

Clinical observation on the therapeutic effect of the argon laser treating choroidal neovascularization of macular area by the way similar to transpupilary thermotherapy

目的观察氩激光类经瞳孔温热疗法治疗黄斑脉络膜新生血管性疾病（CNV）的疗效和安全性。方法选择眼科中心2年间确诊为黄斑脉络膜新生血管病并接受氩激光治疗的患者55例（59只眼），观察治疗前后最佳矫正视力、眼底荧光血管造影（FFA）、光相干断层扫描（OCT）的改变情况，以及并发症、复发率并对其结果进行分析。结果所有患者均经氩绿激光治疗（83．05％治疗1次、16．95％治疗2次）。术后随访6-20月，最佳矫正视力提高者21只眼（35．59％），视力稳定者35只眼（59．32％），3只眼（5．08％）视力下降。FFA、OCT显示CNV萎缩、渗出性视网膜脱离、出血性视网膜色素上皮脱离及黄斑水肿吸收，仅有2只眼（3．39％）出现暗点，但不影响视物，无其他并发症出现。结论氩激光治疗黄斑脉络膜新生血管性疾病安全有效，可使CNV萎缩，出血部位血管闭锁，进而视网膜内积液、积血及视网膜下液吸收，提高或保存患者视力，且经济，被接受范围广。

Objective To study the argon laser treating choroidal neovascularization （CNV） of macular area by the way similar to transpupilary thermotherapy, and to observe its therapeutic effect and safety. Methods Fifty-five cases （59 eyes） diagnosed as CNV of macular area and treated with argon laser therapy were collected in our Department of Ophthalmology for 2 years. The changes of the best corrected visual acuity （BCVA）, fluorescence fundus angiography （FFA） and Optical Coherence Tomography （OCT）, the complication and the recurrence rate were observed pre and post treatment. And the results were analyzed by the method of statistics. Results All patients were treated with argon laser （83.05% was treated 1 time, 16.95% was treated 2 times）. The Postoperative follow-up of 6 to 20 months revealed that the BCVA improved in 21 eyes （35.59%）, remained unaltered in 35 eyes （59.32%） and diminished in 3 eyes （5.08%）. FFA, OCT showed that CNV atrophy, exudative detachment of retina, hemorrhagic retinal pigment epithelium detachment and macular edema resolution, but blindspot not affected vision occurred in 2 eyes （3.39%） without the other complication appeared. Conclusions Argon laser therapy treated CNV of macular area is safe and effective, which makes CNV atrophy, blood vessel atresia in bleeding part, further intraretina fluid and haematocele and subretinal fluid absorption. Patient＇s vision is improved and conserved, and it is economy and accepted generally.