Transpupillary thermal therapy for age-related macular degeneration accompanied with subfoveal choroidal neovascularization
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
- Issue:
- 5
- DOI:
- 10.3760/j.issn:1005-1015.2004.05.003
- Key Word:
- 黄斑变性/治疗;脉络膜新生血管化/治疗;视网膜新生血管化/治疗;物理疗法
Abstract： 目的观察经瞳孔温热疗法(TTT)治疗老年性黄斑变性(AMD)合并中心凹下脉络膜新生血管(CNV)的疗效. 方法采用半导体810红外激光对荧光素眼底血管造影(FFA)和吲哚青绿血管造影(ICGA)检查确诊的AMD合并CNV患者47例51只眼进行治疗.其中,隐匿型CNV40例42只眼,经典型CNV7例9只眼;初诊时平均视力为0.12.根据病灶大小选择光斑直径分别为0.8、1、2、3.0 mm;能量相应为120、160、260、360 mW;时间60 s.治疗后每1 个月随访复查1 次,如有需要,进行重复治疗,治疗次数1～3次.治疗后随访3～33个月,平均随访时间10个月.随访时检查视力、眼底出血和渗出吸收、CNV闭合情况. 结果治疗眼治疗后均无即刻视力下降或其他不适.末诊时平均视力为0.16,与初诊视力相比,68.62%无变化,25.53%增加,7.84%降低.FFA联合ICGA检查显示:治疗后3个月时,隐匿型CNV闭合率为42.86%, 经典型CNV闭合率为22.22%;6个月时,隐匿型CNV闭合率为73.81%,经典型CNV闭合率为66.67%.检眼镜检查显示:治疗后3个月,隐匿型CNV42只眼中,出血和(或)渗出部分或全部吸收,并有厚薄不等的机化瘢痕形成;经典型CNV 9只眼中7只眼出血和渗出减轻;1只眼有新出血.治疗后6个月,27只隐匿型CNV眼中,3只眼又见新出血,其中2只眼较快吸收,保持至12个月时无变化;5只经典型CNV眼中,2只眼有新出血,再次治疗后吸收,随访16个月病情稳定.19只隐匿型CNV眼随访至6个月以上,5只眼出血消失,5只眼有新出血.6个月以上的随访中,共有8只眼可见新出血,其CNV复发率占15.6%. 结论 TTT治疗AMD合并经典型或隐匿型CNV均有一定效果.在较长期随访中,约15.6%的CNV复发,复发患眼经再次治疗仍有好转.
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