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治疗脉络膜特发性新生血管

http://www.cnophol.com 2008-7-15 11:31:12 中华眼科在线

作者单位:1(710004)中国陕西省西安市第四医院眼科;2(710004)中国陕西省西安市,西安古城医院眼科  
作者简介:郑波,男, 副主任医师。  
通讯作者:郑波. [email protected]  
收稿日期:2006-11-23    修回日期:2007-02-14  

Observation of the clinical effect of transpupillary thermotherapy with  retrobulbar injection of triamcinolone  acetonide for idiopathic  choroidal  neovascularization  

Bo Zheng1, Lu Ye1, Wen-Tao Sun1, Yan-Long Li2, Yong Wang1  

1Department of Ophthalmology, Xi'an Fourth Hospital, Xi'an 710004, Shaanxi Province, China; 2Department of Ophthalmology, Xi'an Gucheng Hospital, Xi'an 710004, Shaanxi Province, China  
Correspondence to: Bo Zheng. Department of Ophthalmology, Xi'an Fourth Hospital, Xi'an 710004, Shaanxi Province, China. [email protected]  
Received:2006-11-23    Accepted:2007-02-14  

Abstract  
· AIM:To observe the clinical effect of transpupillary thermotherapy (TTT) with retrobulbar injection of triamcinolone  acetonide(TA) for idiopathic  choroidal  neovascularization (ICNV).   
· METHODS: Eleven  cases  with idiopathic choroidal neovascularization were treated with retrobulbar injection of TA. After cystoid  macular  edema alleviated or even disappeared, TTT  was  perform  on 11 cases. Laser  parameters  were as  follows: spot  diameter  0.9 - 2.0, power 75 - 450μm, time 55 - 60 seconds. By 3 either 4 months of follow-up, Visual acuity, Ophthalmoscope, Fundus Fluorescein Angiography (FFA) and Indocyanine Green Angiography(ICGA) were used to observe the curative effects.  
· RESULTS: Visual acuity were improved in  8 cases  (73%), remained  stable in  2  cases (18%) and declined  in 1 cases (9%) after treatment.  
· CONCLUSION: TTT at  low  power setting  combined  with retrobulbar injection  of TA may  improve the visual acuity and reduce complications  in ICNV.  
· KEYWORDS: transpupillary thermotherapy; triamcinolone acetonide; idiopathic  choroidal  neovascularization  

Zheng B , Ye L , Sun WT , Li YL , Wang Y. Observation of the clinical effect of transpupillary thermotherapy with  retrobulbar injection of triamcinolone  acetonide for idiopathic  choroidal  neovascularization. Int J Ophthalmol (Guoji Yanke Zazhi) ,2007;7(2):571-573  

摘要  
目的:观察经瞳孔温热疗法(transpupillary thermotherapy,TTT)联合球后曲安奈德注射(triamcinolone acetonide,TA)治疗脉络膜特发性新生血管(idiopathic  choroidal neovascularization, ICNV)的治疗效果。  
方法:球后注射曲安奈德使黄斑部水肿、渗出缓解后再使用法国产Iris810nm半导体激光对11例脉络膜特发性新生血管患者进行TTT治疗,采用1.0~2.0nm光斑、能量75~175mW照射时间55~60s,随诊3~4mo,通过视力,直接检眼镜检查,荧光素眼底血管造影(tundus fluorescein angiography, FFA)及吲哚青绿血管造影(indocyanine green angiography, ICGA)观察疗效。  
结果:治疗后视力提高者8例,占73%。无变化者2例18%。视力下降者1例9%。11例患者中眼底改变者10例,1例有瘢痕形成。  
结论:TTT+TA对脉络膜新生血管有较好的疗效,激光能量小,参数较易掌握。  
关键词:经瞳孔温热疗法;曲安奈德;脉络膜特发性新生血管  

郑波,叶璐,孙文涛,李燕龙,王勇. 经瞳孔温热疗法联合曲安奈德球后注射治疗脉络膜特发性新生血管.国际眼科杂志,2007;7(2):571-573  


参考文献  
1 Schmidt-Erfurth U, Miller JM, Sickenberg M. Photodynamic therapy with verteporfin for choroidal neovascularization caused by age-erlated macular degeneration: results of retreatments in aphase 1 and 2 study. Arch Ophthalmol ,1999;117:1177-1187  
2 Macular Photocoagulation Study Group .Argon laser photocoagulation for neovascular maculopathy:five-year results from randomized clinical  trias.Arch Ophthalmol ,1991;109:1109-1114  
3 Shields C, Shields J, Cater J, Lois N,Edelstein C,Gunduz K. Transpupillary thermotherapy for choroidal melanoma:tumor control and results in 100 consecutive eases . Ophthalmology ,1998;103:2142-2151  
4 Newsom RSB, Mcalister JC, Saeed M. Transpupillary thermotherapy (TTT) for the treatment of choroidal neovasculerization.Br J Ophthalmol , 2001;85:173-178  
5王丽丽,朱忠桥,王勇,王海燕. 曲安奈德预防术后增殖性玻璃体视网膜病变临床观察.国际眼科杂志,2005;5(4):685-687  
6胡丹,惠延年,张鹏,白建伟.经瞳孔温热疗法治疗中心性渗出性脉络膜视网膜炎.中华眼底病杂志,2002;3:184-186

(来源:国际眼科杂志)(责编:zhanghui)

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