经瞳孔温热疗法治疗年龄相关性黄斑变性陷匿型脉络膜新生血管的能量选择

目的探讨经瞳孔温热疗法(TTT)治疗年龄相关性黄斑变性隐匿型脉络膜新生血管(CNV)的有效能量。方法运用810 nm激光治疗仪,光斑直径1~3 mm,时间每点60 s,能量随病人的屈光间质、光斑大小及出血量的多少进行调整。以照射区域轻度发灰为限。治疗范围:根据CNV的大小,采用1~4个光斑覆盖。结果37眼治疗后随诊视力3眼提高(8.1%),28眼无变化(75.7%),6眼下降(16.2%)。荧光素眼底血管造影(FFA)复查CNV完全消退者15眼,占40.6%;CNV部分消退者16眼,占43.2%;无变化者6眼,占16.2%。结论TTT是治疗黄斑区隐匿型CNV的有效方法,需进一步探索更为有效的治疗能量。

Optimal laser energy for transpupillary thermotherapy of occult choroidal neovacularization in patients with age-related macular degeneration

Objective To investigate the optimal laser energy of transpupillary thermotherapy for occult choroidal neovascularization in patients with age-related macular degeneration.Methods Thitry seven eyes of occult in degeneration were treated with IRIS 810 nanometers diode laser transpuptllary thermotherapy.Laser beam size was 1.0,2.0 or 3.0 millimeters,respectively.Treatment time was 60 seconds.Power settings were determined according to dioptric media,laser beam size and hemorrhage.Follow up was arranged 4-25 months after treatment.The visual acuity determination,clinical examination and fluorescein were performed.Results During the follow up,vision improved in 3 eyes(8.1%),the visual acuity could be stabilized in 28 eyes(75.7%),and vision decreased in 6 eyes(16.1%).Choroidal neovascularization was closed in 15 eyes(40.6%),and the choroidal meovascularization was partly extinct in 16 eyes(43.2%),and choroidal neovascularization had not improved in 6 eyes(16.2%).Conclusion Transpupillary thermotherapy is a potential treatment for the occult choroidal neovascularization in age-related macular degeneration.Further prospective controlled studies are necessary to confirm the effective energy in the treatment.