目的:观察经瞳孔温热疗法(transpupillary thermotherapy,TTT)治疗黄斑中心区域视网膜色素上皮(retinal pigmentepithelium,RPE)病变的疗效。方法:黄斑中心区域RPE病变患者38例39眼,根据病灶大小选择光斑和能量进行TTT治疗,治疗范围以覆盖渗漏点、RPE脱离范围和其周边失代偿的RPE为度。随访时复查视力、眼底、中心视野及FFA。结果:治疗后患者视力和视野明显好转,治疗后15,30d平均视力分别为0.67±0.26和0.90±0.31,与治疗前视力0.38±0.23比较差异非常显著(t=5.22,8.41,P<0.01)。治疗后2mo,36眼(92%)视力提高,平均视力及平均光敏感度(MS)分别为0.95±0.34和25.46±1.74dB,较TTT前差异有非常显著性(t=8.67,8.84,P<0.01),FFA示36例37眼渗漏均已停止,但有1例在随访期内复发。结论:TTT治疗黄斑中心区域RPE病变简便安全有效,未见明显并发症。

AIM:To investigate the clinical results of transpupillary thermotherapy(TTT) for patients with retinal pigment epithelium(RPE) lesion in central macular region.METHODS:Thirty-eight cases 39 eyes diagnosed with RPE lesion in central macular region by FFA were treated with a diode laser at 810nm.The treatment range was decided by the range of the RPE leakage,RPE detachment or RPE decompensation.Laser parameters were as follows:the diameters of beam spot varied from 800μm to 3000μm,the power from 100mW to 460mW,the duration 60 seconds,beam spots from 1 to 3.The visual acuity,fundus,central visual field and FFA were followed up.RESULTS:The visual acuity and central visual field were improved after laser treatment.The average visual acuity of 39 eyes was 0.5 and 1 month after treatment were 0.67±0.26 and 0.90±0.31 respectively.The difference was significant(t=5.22,8.41,P<0.01) compared with that before the treatment.2 months after treatment the visual acuities increased in 36 eyes(92%).The average visual acuity and mean sensitivity of the 39 eyes were 0.95±0.34 and 25.46±1.74dB respectively.The difference was significant(t=8.67,8.84,P<0.01) compared with the average visual acuity and mean sensitivity before the treatment.FFA showed that fluorescein leakage stopped in 37 eyes.But 1 case recurred during the follow-up time.CONCLUSION:TTT is effective and safe for RPE lesion in the central macular region.

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