经瞳孔温热疗法治疗孤立性脉络膜血管瘤

Transpupillary thermotherapy for circumscribed choroidal hemangioma

目的 观察经瞳孔温热疗法 (transpupillary thermotherapy,TTT)治疗孤立性脉络膜血管瘤的疗效。 方法 回顾分析 12例孤立性脉络膜血管瘤患者 12只患眼采用 TTT治疗的临床疗效。治疗使用 Iris810 nm红外激光 ,能量 2 2 0～ 10 0 0 m W,光斑直径 1.2、2 .0、3.0 mm,照射时间 1～ 2 min。观察治疗前后视力、视网膜下液、脉络膜血管瘤的厚度及渗漏的变化以及治疗的并发症等情况。随访 6～ 16个月 ,平均随访 10个月。 结果 12例脉络膜血管瘤患者中伴有周边视网膜脱离者 8例 ,经 TTT治疗后周边液体完全吸收 6例 ,部分吸收 2例。治疗后视力不变者 7例、提高者 3例、下降者 2例。8例治疗前曾行 B型超声检查者 ,治疗后 B型超声检查 7例瘤体厚度较治疗前降低 ,其厚度平均下降 2 1.75 %。 10例治疗前行荧光素眼底血管造影检查者复查均可见瘤体的渗漏明显减轻。治疗的并发症有视网膜出血 5例、视网膜皱褶 1例。 结论 TTT是治疗脉络膜血管瘤的有效方法 。

Objective To evaluate the clinical effect of transpupillary thermotherapy (TTT) on circumscribed choroidal hemangioma (CCH). Methods The clinical data of 12 eyes of 12 patients with CCH treated with TTT were retrospectively analysed. Infrared diode laser Iridex, oculight SLX was used in TTT at 810 nm and power between 220 and 1 000 mW with a beam diameter of 1.2 or 2 0 or 3 0 mm, with 1 to 2 minutes of exposure time. The visual acuity , subretinal fluid , complication ,thickness and hyperfluorescence of CCH were observed pre and postoperatively in the treated eyes. The average period of follow up was 10 months (6 16 months). Results Among the 8 eyes with peripheral retinal detachment in 12 cases of CCH the peripheral subretinal fluid was completely absorbed in 6 eyes, and partially absorbed in 2 eyes after TTT treatment. In 8 patients undergone ultrasonography, the mean value of tumor thickness went down by 21.75 % in 7 eyes. The resultant visual acuity after treatment was improved in 3 eyes, maintained no change in 7 eyes and reduced in 2 eye. The fundus fluorescein angiography in 10 eyes revealed a significant decrease of the leakage in tumor. Postoperative complication of TTT in the 12 eyes included retinal hemorrhage (5 eyes) and retinal fold (1 eye). Conclusion TTT is an effective treatment for CCH.