经瞳孔温热疗法治疗眼内肿瘤疗效观察

Effect of transpupillary thermotherapy on the treatment of intraocular tumors

目的 观察经瞳孔温热疗法 ( transpupillary thermotherapy,TTT)治疗眼内肿瘤的临床效果。 方法 对 5 0例临床诊断为眼内肿瘤的患者 (脉络膜血管瘤 37例 ,视网膜血管瘤 2例 ,脉络膜骨瘤 5例 ,脉络膜黑色素瘤 4例 ,视网膜母细胞瘤 2例 )行 TTT治疗及 1～ 2 0个月随访观察。 结果 脉络膜血管瘤 30例复诊 ,平均随访 5 .1个月。其中 2 9例瘤体萎缩 ,色素沉着 ,视网膜脱离及视网膜下液部分或全部复位、吸收 ,占复诊患者的 96 .7%;1例无效 ,占 3.3%。视力不变者 2 4例 ,占 80 .0 %;增进者 4例 ,占13.3%;下降者 2例 ,占 6 .7%。视网膜血管瘤 2例均无效。脉络膜骨瘤 4例 5只眼复诊 ,平均随访 6个月。1只眼瘤体无变化 ,其余 4只眼瘤体均萎缩 ,视力不变者 3只眼 ;增进及下降各 1只眼。脉络膜黑色素瘤 4例复诊 ,平均随访 8个月。瘤体缩小 1例 ,不变 2例 ,增大 1例。视力不变及下降各 2例。视网膜母细胞瘤2例瘤体均有不同程度萎缩 ,1例小儿随访 2 0个月 ,无法行视力检查 ,另 1例随访 3个月视力不变。所有患者治疗及随访期间未发现严重并发症。 结论除视网膜血管瘤外 ,TTT对部分眼内肿瘤临床疗效肯定 ,副作用少 ,是一种很有潜力的眼内肿瘤治疗方法。

Objective To evaluate the effect of transpupillary thermotherapy (TTT) on the treatment of intraocular tumors. Methods A total of 50 patients with intraocular tumors, including 37 choroidal hemangioma, 2 retinal capillary hemangioma, 5 choroidal osteoma, 4 choroidal melanoma, and 2 retinoblastoma (RB) underwent TTT and were followed up for 1～20 months. Results In 30 patients with choroidal hemangioma (average follow-up was 5.1 months), 29 (96.7%) had pigment scarring in different levels and the retinal detachemnts were partly or completely recovered; 1 had no obvious improvement. The visual acuity was unchanged in 24 (80.0%) patients, improved in 41 (13.3%) and declined in 2 (6.7%). In 2 patients with retinal capillary hemangioma, no effect was found. In 5 eyes (4 patients) with choroidal osteoma (average follow-up was 6 months), no change of the tumor was found in 1 and the atrophic spots were seen in 4; the visual acuity was unchanged in 3, improved in 1 and declined in 1. In 4 patients with choroidal melanoma (average follow-up was 8 months), the tumor was shrunken in 1, unchanged in 2, and enlarged in 1; the visual acuity was unchanged in 2 and declined in 2. In 2 patients with RB, RB was totally shrunken in 1 and partly shrunken in 1. Visual acuity of one child patient who was followed up for 20 months could not be examined, and was unchanged in another one who was followed up for 3 months. No severe complications were found in the patients during the treatment and the follow-up. Conclusions TTT is effective for the treatment of some intraocular tumors except retinal capillary hemangioma. It is a kind of potential treatment for intraocular tumors with few side-effect.