[关键词]
[摘要]
目的：探讨低能量经瞳孔温热疗法(transpupillary thermotherapy，TTT)联合曲安奈德(triamcinolone acetonide，TA)球后注射治疗中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy，CEC)的临床效果及安全性。
方法：对14例14眼CEC患者首先球后注射TA 40mg/1mL+20g/L利多卡因0.5mL，然后于注射后1wk时再使用810nm半导体激光进行低能量TTT治疗(激光参数分别为：光斑直径0.8～3.0mm，照射时间60s，能量120～360mW)，采用矫正视力、直接检眼镜、荧光素眼底血管造影(fundus fluorescein angiography，FFA)及光相干断层扫描(optical coherence tomography， OCT)来观察治疗后的效果及不良反应，随访3～12mo。
结果：治疗后视力提高者5眼(36%)，无变化者8眼(57%)，视力下降者1眼(7%)。12眼在治疗2wk后黄斑区出血、渗出明显减少，其中5眼在1mo后完全吸收，7眼在3mo后完全吸收，2眼眼底出现明显的黄斑瘢痕形成。治疗后3mo时，FFA检查发现CNV渗漏明显消退、减轻者7眼，无明显变化者5眼，2眼CNV扩大或渗漏增强； OCT检查发现12眼黄斑水肿均有不同程度改善，CNV强反射区域减小或者稳定，另2眼黄斑水肿加重、CNV扩大。
结论：低能量TTT联合TA球后注射对CEC有较好的治疗效果，临床上值得应用。
[Key word]
[Abstract]
AIM: To observe the clinical effect of low power transpupillary thermotherapy(TTT)with retrobulbar injection of triamcinolone acetonide(TA)for central exudative chorioretinopathy(CEC).
METHODS: Fourteen eyes with idiopathic choroidal neovascularization were treated with retrobulbar injection of TA and performed by low power TTT after one week. Laser parameters were as follows: spot diameter 0.8-3.0mm, low power 120-360mW, time 60 seconds. By 3 to 12 months of follow-up, visual acuity, ophthalmoscope, fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were used to observe the curative effects.
RESULTS: Visual acuity were improved in 5 eyes(36%), remained stable in 8 eyes(57%)and declined in 1 eye(7%)after treatment. The macular hemorrhage and exudation were reduced significantly in 12 eyes. FFA showed that the fluorescein leakage ceased or decreased in 7 eyes, unchanged in 5 eyes, and enlarged in 2 eyes. The macular edema of 12 eyes in OCT was reduced unequally.
CONCLUSION: Low power TTT combined with retrobulbar injection of TA shows good therapeutic effect on CEC.
[中图分类号]
[基金项目]
南京军区“十一五”医药卫生基金资助课题(No.08MA083)
