经瞳孔温热疗法联合曲安奈德球后注射治疗脉络膜特发性新生血管.docVIP

经瞳孔温热疗法联合曲安奈德球后注射治疗脉络膜特发性新生血管 作者：郑波　叶璐　孙文涛　李燕龙　王勇 【摘要】 　　目的：观察经瞳孔温热疗法（transpupillary thermotherapy,TTT）联合球后曲安奈德注射(triamcinolone acetonide，TA)治疗脉络膜特发性新生血管（idiopathic choroidal neovascularization， ICNV）的治疗效果。方法：球后注射曲安奈德使黄斑部水肿、渗出缓解后再使用法国产Iris810nm半导体激光对11例脉络膜特发性新生血管患者进行TTT治疗，采用1.0～2.0nm光斑、能量75～175mW照射时间55～60s，随诊3～4mo，通过视力，直接检眼镜检查，荧光素眼底血管造影（tundus fluorescein angiography， FFA）及吲哚青绿血管造影（indocyanine green angiography， ICGA）观察疗效。 结果：治疗后视力提高者8例，占73%。无变化者2例18%。视力下降者1例9%。11例患者中眼底改变者10例，1例有瘢痕形成。结论：TTT+TA对脉络膜新生血管有较好的疗效，激光能量小,参数较易掌握。 【关键词】 经瞳孔温热疗法　曲安奈德　脉络膜特发性新生血管 　　Observation of the clinical effect of transpupillary thermotherapy with retrobulbar injection of triamcinolone acetonide for idiopathic choroidal neovascularization Abstract AIM:To observe the clinical effect of transpupillary thermotherapy (TTT) with retrobulbar injection of triamcinolone acetonide(TA) for idiopathic choroidal neovascularization (ICNV). METHODS: Eleven cases with idiopathic choroidal neovascularization were treated with retrobulbar injection of TA. After cystoid macular edema alleviated or even disappeared, TTT was perform on 11 cases. Laser parameters were as follows: spot diameter 0.9 - 2.0, power 75 - 450μm, time 55 - 60 seconds. By 3 either 4 months of follow-up, Visual acuity, Ophthalmoscope, Fundus Fluorescein Angiography (FFA) and Indocyanine Green Angiography(ICGA) were used to observe the curative effects. RESULTS:　Visual acuity were improved in 8 cases (73%), remained stable in 2 cases (18%) and declined in 1 cases (9%) after treatment.CONCLUSION: TTT at low power setting combined with retrobulbar injection of TA may improve the visual acuity and reduce complications in ICNV. ?KEYWORDS: transpupillary thermotherapy; triamcinolone acetonide; idiopathic choroidal neovascularization 　　 0引言 特发性脉络膜新生血管(idiopathic choroidal neovascularization， ICNV)的发病机制主要为无任何明显病因的黄斑区脉络膜新生血管（CNV）形成，引起视网膜下出血，渗出，水肿。病程持久可形成黄斑区纤维瘢痕，导致中心视力永久损害。曾有人用810nm近红外激光进行治疗特发性