经瞳孔温热疗法治疗限局性脉络膜血管瘤

目的探讨经瞳孔温热疗法治疗限局性脉络膜血管瘤的临床效果。方法经眼底检查和荧光素眼底血管造影确诊为限局性脉络膜血管瘤的患者10例（10只眼）,年龄16—48岁,平均34岁。采用经瞳孔温热疗法,以810红外激光对病变区连续照射1～5个光斑,光斑直径3．0mm,将肿物完全覆盖。激光功率为800～1200mw,照射时间60s,或延长10～20s。术后1—3个月随诊。视病情需要可重复治疗1～3次。患者随访期3～36个月,平均14个月。其中4例患者为首次治疗;6例曾接受绿激光（氪和氩）光凝治疗。结果末诊时,有1例脉络膜血管瘤患者病变正位于黄斑中心区,视网膜下尚有积液,眼底有透红光区,需继续治疗,余9例视网膜下积液完全消退,荧光素眼底血管造影和吲哚氰绿脉络膜血管造影检查,肿瘤区无强荧光出现,视力增进;经过半年至2年随诊,患者病情稳定。未发生术后并发症或后遗症。结论经瞳孔温热疗法治疗限局性脉络膜血管瘤的临床效果肯定。无论单独作为首选治疗或用于补充以前光凝治疗的不足,均可获得良好效果。（中华眼科杂志,2005,41：882-886）

Transpupillary thermotherapy for circumscribed choroidal hemangioma

Objective To evaluate the efficacy of transpupillary thermotherapy (TTT) on circumscribed choroidal hemangioma. Methods Ten eyes of 10 cases with circumscribed choroidal hemangioma (age 16-48,average 34.4) were included in the present study. Six cases had previous green laser (4 argon and 2 krypton) photocoagulation, TTT as a primary treatment was used for other 4 cases without previous laser application. Fluorescein angiography, visual acuity, anterior segment and fundus examination, perimetry test, FFA /ICGA and ultrasonography were performed in all patients before the treatment. One to five infra red diode laser spots (810 nm with power of 800 -1200 mW, diameter of 3 mm) were delivered on the surface of tumor with 60 seconds exposure, additional 10-20 seconds exposure was used in some cases. Second treatment was given 1-3 month later if there was active leakage demonstrated by fluorescein angiography. The followed-up period was 6-36 months (averaged 14.5 month). Results After transpupillary thermotherapy, 9 eyes (90%) showed partial regression of the tumor. Average visual acuity was 0.25 and 0.6 before and after TTT, respectively. Six patients showed improvement of vision acuity, but vision acuity in 4 patients with cystic macular degeneration remained unchanged. No recurrences were observed within follow-up averaged 14.5 months. Transpupillary thermotherapy did not associate with any significant complications.Conclusion Transpupillary thermotherapy is effective to treat circumscribed hemangioma of choroid either as a primary treatment or supplementary therapy to previous laser photocoagulation.