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目的:报告 1 例湿性年龄相关性黄斑变性(AMD) 在多次经瞳孔温热疗法(TTT) 后,脉络膜新生血管(CNV)消退,但发生了视网膜色素上皮(PRE)和脉络膜的萎缩并伴低视力。方法: 复习包括眼底照相、眼底荧光素血管造影( FFA)、靛青绿血管造影和干涉光断层扫描在内的临床资料。结果: 男性 72 岁主诉左眼视物模糊,FFA证实为黄斑部息肉状脉络膜血管病变。其左眼的 CNV未经任何治疗在6a 间保持 0.1 的视力。约 2a 后,右眼出现一片 CNV。在此后 3a 内,病灶保持或大(3×5PD)或小(1×2PD)并伴有明显渗出和出血,先后做了 7 次 TTT,参数为 80￣280mW、2mm光斑、曝光 60s,每次间隔 3mo以上。CNV病灶最终消退,但黄斑部遗留白色区,视力由 0.3降至 0.04。结论:TTT可使 CNV病灶消退,但可发生明显的 RPE和脉络膜萎缩,这无益于视力。如果对亚洲患者应用 TTT,其参数可低于 120mW/mm,限于 2 次。
PURPOSE: To report a case of wet age-related macular degeneration (AMD) subchondral thermotherapy (TTT) after choroidal neovascularization (CNV) subsided, but retinal pigment epithelium (PRE) and choroidal atrophy and accompanying Low vision. Methods: Review of clinical data including fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography and interferometric light tomography. Results: The 72-year-old male complained of blurred vision in the left eye and FFA confirmed polypoidal choroidal vasculopathy in the macula. The CNV of the left eye maintained visual acuity of 0.1 at 6 days without any treatment. After about 2a, a CNV appeared in the right eye. In the subsequent 3 years, the lesion remained either large (3 × 5PD) or small (1 × 2PD) accompanied by significant exudation and bleeding. Seven TTTs were performed, with parameters of 80-280 mW, 2 mm spot, and exposure time of 60 s Intervals of more than 3mo. CNV lesions eventually subsided, but left the white area of the macular area, visual acuity decreased from 0.3 to 0.04. CONCLUSIONS: TTT regresses CNV lesions but produces significant RPE and choroidal atrophy, which is not good for visual acuity. If TTT is applied to Asian patients, the parameter may be less than 120 mW / mm, limited to two.