经瞳孔温热疗法治疗中心性渗出性脉络膜视网膜炎的疗效观察

Transpupillary thermotherapy of central exudative chorioretinopathy

目的 探讨经瞳孔温热疗法 (traspupillary thermotherapy,TTT)治疗中心性渗出性脉络膜视网膜炎 (central exudative chorioretinopathy,CEC)的临床效果。 方法 对荧光素眼底血管造影 (fundusfluorescein angiography,FFA)和吲哚青绿血管造影 (indocyanine green angiography,ICGA)检查确诊的CEC患者的 12只患眼进行 TTT治疗。采用 810 nm半导体激光 ,光斑 0 .5～ 2 .0 mm,照射时间 5 5～ 6 0 s,能量 2 0 0～ 35 0 m W,对 FFA和 ICGA图像所显示的脉络膜新生血管 (choroidal neovascularization,CNV)进行照射 ,照射区未出现颜色变化或呈淡灰色。对比分析患者治疗前后的视力、眼底、 FFA和 ICGA检查结果。 结果 TTT治疗后 0 .5～ 3个月后所有患眼视力都有不同程度提高 ,视力提高 5行以上者 4只眼 ,占 33.3% ;3～ 5行者 5只眼 ,占 4 1.7% ;1～ 2行者 3只眼 ,占 2 5 .0 %。治疗后 10只眼行 FFA和 ICGA复查 ,其中 FFA复查荧光素渗漏消失 7只眼 ,减轻 3只眼 ;ICGA复查 CNV消失或明显缩小 8只眼 ,CNV无变化 2只眼。 结论 TTT治疗 CEC效果良好 。

Objective To evaluate the effects of traspupillary thermotherapy (TTT) for the treatment of central exudative chorioretinopathy (CEC). Methods Twelve eyes of 12 patients who suffered from CEC were treated by using a diode laser at 810 nm. A variable spot size of 0.5 mm 2 0 mm was used depending on the size of choroidal neovascularization (CNV).The treatment was initiated in one spot for 55 to 60 seconds duration at a power range between 200 350 mW, and the treated area revealed no visible color change to a light gray appearance. Preoperative and postoperative fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 10 of the 12 eyes. Results The visual acuity in all eyes was improved to different degree over a period of 3 10 months. Five or more lines improvement measured by Snellen chart in visual acuity was found after the treatment in 4 eyes, three to five lines in 5 eyes and one to two lines in 3 eyes. All eyes demonstrated decreased or vanished exudation in FFA. CNV disappeared or decreaced in 8 eyes and remained nochange in 2 eyes in ICGA. Conclusion TTT is obviously effective in treating CEC.