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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。
Objective To investigate the clinical effect of transpupillary thermotherapy for limited choroidal hemangioma. Methods Ten patients (10 eyes) diagnosed with limited choroidal hemangiomas by fundus examination and fundus fluorescein angiography were aged from 16 to 48 years with an average of 34 years. By transpupillary thermotherapy, with 810 infrared laser on the lesion area continuous irradiation of 1 to 5 spots, spot diameter 3.0mm, the tumor completely covered. Laser power 800 ~ 1200mW, irradiation time 60s, or extended 10 ~ 20s. 1 to 3 months follow-up. Depending on the condition can be repeated treatment of 1 to 3 times. Patients were followed up for 3 to 36 months, an average of 14 months. Four of the patients were treated for the first time; six had photocoagulation with green laser (krypton and argon). Results At the end of diagnosis, 1 patient with choroidal hemangioma was located in the center of the macular area, there was effusion under the subretinum, and there was a red-light area in the fundus. Treatment was continued and the remaining 9 subretinal fluid completely subsided. The fluorescein fundus Angiography and indocyanine green choroidal angiography, no strong fluorescence in the tumor area, visual acuity; after six months to 2 years follow-up, patients with stable disease. No postoperative complications or sequelae occurred. Conclusions The clinical effect of mydriasis by thermotherapy for the treatment of limited choroidal hemangioma is certain. Either alone or as a supplement to the previous treatment of photocoagulation, can be achieved good results.