光学相干断层扫描在经瞳孔温热疗法治疗老年性黄斑变性中的应用

目的　探讨光学相干断层扫描 (OCT)对经瞳孔温热疗法 (TTT)治疗渗出型老年性黄斑变性 (AMD )的临床应用价值。方法　对渗出型AMD3 5例 ( 3 6眼 )进行光学相干断层扫描(OCT)、荧光素眼底血管造影 (FFA)、吲哚青绿脉络膜血管造影 (ICGA )检查。根据FFA、ICGA和OCT检查结果 ,明确CNV位置、范围和大小 ,采用半导体红外激光 ( 810nm)进行TTT治疗 ,并对其疗效进行评价。结果　TTT治疗后视力提高者 10眼 ,占 2 7 8% ;视力稳定不变者 17眼 ,占47 2 % ;视力下降者 9眼 ,占 2 5 %。OCT复查结果为 11眼 ( 3 0 6% )黄斑水肿消失 ;14眼( 3 8 9% )黄斑水肿减轻 ;8眼 ( 2 2 2 % )无变化 ;3眼 ( 8 3 % )黄斑水肿加重。CNV消失 12眼( 3 3 3 % ) ,CNV缩小 19眼 ( 5 2 8% ) ,CNV无变化 3眼 ( 8 3 % ) ,CNV增大 2眼 ( 5 6% ) ;治疗后视网膜厚度明显变薄 (P <0 0 0 1)。黄斑中心凹视网膜神经上皮层厚度与视力呈负相关 (r =0 4963 ,P =0 0 0 1)。结论　OCT可客观、精确地显示CNV的位置、大小范围及视网膜水肿的变化程度 ,对指导TTT治疗AMD和疗效评价有着重要价值。

The application of optical coherence tomography in transpupillary thermotherapy for age-related macular degeneration

Objective To verify the applicable significance of optical coherence tomography (OCT) in transpupillary thermotherapy(TTT)for age-related macular degeneration(AMD).Methods Thirty-five cases(36 eyes)of exudative AMD were managed with TTT.Before and post-treatment,all cases underwent OCT,fluorescein angiography(FFA) and indocyanine green angiography(ICGA).TTT was delivered using a 810 nm diode laser.Results The visual acuities of last visit were compared with those before the treatment.The visual acuity was improved in 10 eyes(27.8%),unchanged in 17 eyes(47.2%),and declined in 9 eyes(25%).OCT was re-done and compared with OCT images before TTT treatment.The macular edema was disappeared 11 eyes(30.6%),decreased in 14 eyes(38.9%),unchanged in 8 eyes(22.2%),and increased in 3 eyes(8.3%).CNV was disappeared or decreased in 31 eyes(86.1%),unchanged in 3 eyes(8.3%),and progressed in 2 eyes(5.6%).The retinal thickness was decreased obviously (P<0.001).The statistical analysis showed there was a negative correlation between the thickness of fovea and visual acuity(r=-0.4963,P=0.001).Conclusions OCT can precisely show the loaction,size and changes of retinal thickness and has an important significance in TTT for AMD.