Transpupillary Thermotherapy of Choroidal Neovascularization in Patients with Age-Related Macular Degeneration

經瞳孔熱雷射療法應用於老年性黃斑部退化併發脈絡膜新生血管之病患的效果

曾國亮(Gow-Lieng Tseng) ； 黃世欣(Shih-Hsin Huang)

《中華民國眼科醫學會雜誌》 44卷2期 (2005/06) Pp. 73-83

https://doi.org/10.30048/ACTASOS.200506.0004

摘要

目的：評估經瞳孔熱雷射療法應用於老年性黃斑部退化併發脈絡膜新生血管之病患的效果。
方法：48位病患（56隻眼）接受治療，依病灶範圍決定雷射直徑(0.5-3.0mm)及雷射能量(60-400mw)，雷射暴露時間以60秒為原則。術後回診時，實施完整的眼科檢查並記錄。
結果：病患術後平均追蹤期12.2個月（2-26月），最後門診時，視力進步或維持穩定的比率為80.4%。除一位病患產生網膜色素上皮萎縮外，其餘病患並無明顯併發症的產生。
結論：對於老年性黃斑部退化併發脈絡膜新生血管的患者，只要劑量的選擇不要過度，經瞳孔熱雷射療法應該是一種安全穩定且有效的治療方法，並無明顯的副作用或併發症。

並列摘要

Purpose: To evaluate the efficacy of transpupillary thermotherapy (TTT) for the treatment of choroidal neovascularization (CNV) in patents with age-related macular degeneration (ARMD).
Methods: Fifty-six eyes of 48 patients with CNV secondary to ARMD were treated with diode laser (810nm) TTT. A variable spot size (0.5mm, 0.8mm, 1.2mm, 2.0mm or 3.0mm) was used depending on the size of lesion. Power setting ranged between 60mw and 400mw. Treatment was given in each lesion for 1 minute, and the end point was no visible color change or light-gray appearance of the retina. Outcome was assessed with Snellen visual acuity, fluorescein angiography and clinical examination. Retreatment was performed if persistent leakage was noted 2 months later.
Results: Nineteen predominantly classic CNV and 37 predominantly occult membranes were followed up for a mean of 12.2 months (range 2-26). Five eyes (8.9%) showed a two-or-more-line improvement in visual acuity (VA). Visual acuity remained stable (VA change within one line) in 40 treated eyes (71.4%). Visual acuity was stabilized or improved in 15 eyes (78.9%) with classic CNV and in 30 eyes (81.1%) with occult CNV. No significant complication except one presented as retinal pigment epithelium (RPE) atrophy after laser treatment.
Conclusions: TTT is a potential treatment with rare significant complications for CNV secondary to ARMD. The long-term effect and standard treatment protocol of TTT should be determined in the further study.

並列關鍵字

Transpupillary thermotherapy ； Choroidal neovascularization classic or occult ； Age-related macular degeneration ； Fluorescein angiography