经瞳孔温热疗法治疗高度近视眼的脉络膜新生血管

目的：评价经瞳孔温热疗法(tmmpupillary ther-motherapy,TTT)治疗高度近视眼的黄斑区脉络膜新生血管膜(choroidal meovascularization,CNV)的疗效。方法：对17例21眼黄斑区具有QⅣ的高度近视患者进行TTT治疗，并定期随访，观察治疗前后视力、眼底、眼底荧光造影(fundus fluores-cein angiogmphy，FFA)及吲哚青绿眼底血管造影(indocyanine green angiogaphy，ICGA)的变化。结果：治疗后21眼中视力提高仅4眼，稳定8眼，下降9眼。治疗过程中有4眼发生脉络膜出血，1眼治疗后CNV仍反复生长。最终有16眼眼底出血渗出的情况得到改善。结论：经瞳孔温热疗法可以减少因脉络膜新生血管膜而引起的出血及渗出，加速疤痕化，对封闭黄斑区CNV有一定的疗效，但高度近视患者的CNV进行TTT治疗时能量较难控制，容易出血，对中心视力的恢复有一定的影响，应谨慎选择治疗方式。

Transpupillary thermotherapy for choroidal neovascularization in high myopia

Objective: To evaluate the efficacy of transpupillary ther-motherapy(TTT) in the treatment of choroidal neovascularization(CNV) in the macular area of the high myopic eye. Methods: Transpupillary thenmtherapy was performed on 21 eyes of 17 patients with high myopia who suffered from CNV in the macular area. Visual acuity was tested before and after treatment. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were done before and after treatment. Results: Visual acuity improved in only 4 eyes, remained stable in 8 eyes and became worse in 9 eyes after treatment. Choroidal hemorrhage occurred in 4 eyes and was still occurring in 1 eye. And the condition of the fundus improved in 16 eyes. Conclusion :TTT can reduce exudation and hemorrhage caused by CNV, resulting in faster cicatrization of the CNV complex. It proved to be an acceptable therapy. However, laser energy is more difficult to control and choroidal hemorrhage seems to be more likely to occur in the high myopic eye during treatment than for other conditions that cause CNV. And this affects the recovery of central visual acuity. Decisions to use this therapy for treatment should be made with caution.