激光经瞳孔温热疗法治疗高度近视性黄斑下脉络膜新生血管

Laser Transpupillary Thermotherapy for the Treatment of Choroidal Neovascularization in High Myopia

目的观察激光经瞳孔温热疗法对高度近视性黄斑下脉络膜新生血管的治疗效果及其安全性。方法使用IRIS810nm半导体激光对26例28眼经眼底荧光素血管造影及吲哚青绿血管造影诊断为黄斑下脉络膜新生血管的高度近视患者进行了激光经瞳孔温热治疗。男10例11眼,女16例17眼,平均年龄40.2岁。屈光度-6.00～-12.00,均伴有不同程度矫正视力下降、注视性暗影、视物变形等临床症状。采用光斑直径为1.2、2.0及3.0mm光斑,功率为100～300mW的激光照射60s。6眼进行了2次治疗。随访4～40周,通过视力、直接眼底镜检查、眼底荧光素血管造影及吲哚青绿血管造影观察治疗效果。结果治疗后,矫正视力提高>2行者10眼(36%),无变化者16眼(57%),视力下降者2眼(7%)。12眼注视性暗影及视物变形等症状有程度不同的改善,眼底检查出血渗出完全消退或减轻者共6眼。复查眼底造影者中7眼脉络膜新生血管明显消退、出血减轻。结论激光经瞳孔温热疗法治疗高度近视性黄斑下脉络膜新生血管出血有一定的效果,该法较安全、经济。但其治疗参数、远期疗效及并发症仍需更大样本的长期临床观察。

Objective To assess the effectiveness and safety of laser transpupillary thermotherapy(TTT)for the treatment of choroidal neovascularization in high myopia.Methods Twenty eight eyes of choroidal neovascularization in high myopia were treated with IRIS810nm diode laser TTT.Laser beam size was1.0,2.0or3.0mm,respectively and power settings between100 - 300mW,treatment time was60s.Follow up was arranged at4 - 40weeks after treatment .The visual acuity,clinical examination and fluorescein or indocyanine green an-giography were performed.Results During the follow up,vision improved in10eyes(36%),the visual acuity could be stabilized in16eyes(57%),and vision decreased in2eyes(7%).Choroidal neovascularization was closed in7eyes,and the exudate was lighten.The symp-tom was alleviated in12patients,the fundus examination was improved in6eyes.Conclusions Transpupillary thermotherapy is a potential treatment for the choroidal neovascularization in high myopia.Further prospective controlled studies should be necessary to confirm these data.