低能量TTT联合曲安奈德球后注射治疗中心性渗出性脉络膜视网膜病变
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南京军区“十一五”医药卫生基金资助课题(No.08MA083)


Low power transpupillary thermotherapy with retrobulbar injection of triamcinolone acetonide for central exudative chorioretino- pathy
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Supported by the 11th Five-Year Medicine and Health Foundation of Nanjing Military Region, China(No.08MA083)

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    摘要:

    目的:探讨低能量经瞳孔温热疗法(transpupillary thermotherapy,TTT)联合曲安奈德(triamcinolone acetonide,TA)球后注射治疗中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy,CEC)的临床效果及安全性。

    方法:对14例14眼CEC患者首先球后注射TA 40mg/1mL+20g/L利多卡因0.5mL,然后于注射后1wk时再使用810nm半导体激光进行低能量TTT治疗(激光参数分别为:光斑直径0.8~3.0mm,照射时间60s,能量120~360mW),采用矫正视力、直接检眼镜、荧光素眼底血管造影(fundus fluorescein angiography,FFA)及光相干断层扫描(optical coherence tomography, OCT)来观察治疗后的效果及不良反应,随访3~12mo。

    结果:治疗后视力提高者5眼(36%),无变化者8眼(57%),视力下降者1眼(7%)。12眼在治疗2wk后黄斑区出血、渗出明显减少,其中5眼在1mo后完全吸收,7眼在3mo后完全吸收,2眼眼底出现明显的黄斑瘢痕形成。治疗后3mo时,FFA检查发现CNV渗漏明显消退、减轻者7眼,无明显变化者5眼,2眼CNV扩大或渗漏增强; OCT检查发现12眼黄斑水肿均有不同程度改善,CNV强反射区域减小或者稳定,另2眼黄斑水肿加重、CNV扩大。

    结论:低能量TTT联合TA球后注射对CEC有较好的治疗效果,临床上值得应用。

    Abstract:

    AIM: To observe the clinical effect of low power transpupillary thermotherapy(TTT)with retrobulbar injection of triamcinolone acetonide(TA)for central exudative chorioretinopathy(CEC).

    METHODS: Fourteen eyes with idiopathic choroidal neovascularization were treated with retrobulbar injection of TA and performed by low power TTT after one week. Laser parameters were as follows: spot diameter 0.8-3.0mm, low power 120-360mW, time 60 seconds. By 3 to 12 months of follow-up, visual acuity, ophthalmoscope, fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were used to observe the curative effects.

    RESULTS: Visual acuity were improved in 5 eyes(36%), remained stable in 8 eyes(57%)and declined in 1 eye(7%)after treatment. The macular hemorrhage and exudation were reduced significantly in 12 eyes. FFA showed that the fluorescein leakage ceased or decreased in 7 eyes, unchanged in 5 eyes, and enlarged in 2 eyes. The macular edema of 12 eyes in OCT was reduced unequally.

    CONCLUSION: Low power TTT combined with retrobulbar injection of TA shows good therapeutic effect on CEC.

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徐建锋,李贵洲,叶瑞珍.低能量TTT联合曲安奈德球后注射治疗中心性渗出性脉络膜视网膜病变.国际眼科杂志, 2013,13(8):1685-1687.

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  • 收稿日期:2013-01-24
  • 最后修改日期:2013-07-11
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  • 在线发布日期: 2013-07-29
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