摘要
目的:对比观察在孤立性脉络膜血管瘤(circumscribed choroidal hemangioma,CCH)的治疗中,光动力学疗法(photodynamic therapy,PDT)与经瞳孔温热疗法(transpupillary thermotherapy,TTT)的临床疗效。方法:选取CCH患者24例24眼,应用TTT治疗12例,PDT治疗12例。观察患眼治疗前后最佳矫正视力;眼底彩色照片,检眼镜下观察瘤体变化;B超或彩色多普勒检查瘤体大小、高度变化;光学相干断层扫描检查浆液性视网膜下积液的变化;荧光素血管造影及吲哚菁绿血管造影判断瘤体渗漏情况及并发症等。结果:所有患者经治疗后眼底检查均可见视网膜下浆液性渗出消失,彩色多普勒超声示瘤体萎缩,视网膜平伏,血流呈阴性,荧光素血管造影联合吲哚菁绿血管造影可见瘤体血管荧光渗漏减轻,光学相干断层扫描示黄斑及瘤体浆液性视网膜脱离完全平伏,瘤体平复。TTT治疗患者12例12眼术后视力提高、稳定、下降比例,各占33.3%;眼底观察可见瘤体萎缩瘢痕,机化,大量色素增生或色素缺失,部分血管闭塞。PDT治疗患者12例12眼,视力提高者66.7%,视力稳定者33.3%,无视力下降;眼底观察可见瘤体萎缩呈白色,轻度色素紊乱,视网膜及脉络膜正常血管未见损害。结论:TTT与PDT治疗CCH,均能使瘤体萎缩并促进渗出吸收,但PDT对眼底正常组织损伤明显小于TTT,具有更高的安全性。
AIM： To observe the clinical therapeutic effect of photodynamic therapy （ PDT ） and transpupillary thermotherapy （ TTT ） on circumscribed choroid hemangioma （ CCH） . METHODS： Totally 24 cases （ 24 eyes ） of CCH were selected in this study. Twelve of them had undergone TTT, and the other 12 were treated by PDT.The changes of tumors were examined by best corrected visual acuity, results of fundus photography, and direct ophthalmoscopy; the changes of tumors＇sizes and heights were examined by B-ultrasound examination and coloured doppler imaging; the presence of serous subretinal fluid were examined by optical coherence tomography （ OCT ）; the leakage of tumors and complications were analyzed by fluorescence fundus angiography （ FFA ） and indocyanine green angiography （ ICGA） . RESULTS： In all cases, the tumors shrinked back, the blood flows tuned negative, the fluorescence leakages lessened and the serous retinal detachments resolved completely according to OCT, FFA, ICGA and coloured doppler imaging.In the 12 patients treated by TTT, visual acuity improved in 33.3%, unchanged in 33.3%, and droped in 33.3% too; the results of fundus examinations showed obvious pigmentation and atrophy tumor with organized scar.In the 12 patients treated by PDT, visual acuity improved in 66.7%, unchanged in 33.3%, and none droped;the results of fundus examinations showed＆amp;nbsp;slight pigment derangement, atrophy tumor tuned white, and normal blood vessel undamaged. CONCLUSION： Both TTT and PDT can make the tumor atrophy and the exudation absorbed.Unlike TTT, PDT damages little normal tissue, and has higher security.
出处
《国际眼科杂志》
CAS
2014年第3期499-502,共4页
International Eye Science
关键词
孤立性脉络膜血管瘤
光动力学疗法
经瞳孔温热疗法
维替泊芬
circumscribed choroidal hemangioma
photodynamic therapy
transpupillary thermotherapy
Verteporfin
