光动力学疗法与经瞳孔温热疗法治疗孤立性脉络膜血管瘤的临床疗效观察

发布时间：2018-04-16 08:32

本文选题：孤立性脉络膜血管瘤/局限性脉络膜血管瘤 + 光动力学疗法　；参考：《中国医科大学》2010年硕士论文

【摘要】： 目的观察光动力学疗法(photodynamic therapy, PDT)与经瞳孔温热疗法(transpupillary thermotherapy, TTT)治疗孤立性脉络膜血管瘤(circumscribed choroidal hemangioma, CCH)的临床疗效。方法 CCH患者12例12只眼,应用TTT治疗6例,PDT治疗6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；以及并发症等。结果 12例患者(12只眼)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复,瘤体平复。6例TTT治疗患者(6只眼)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治疗后6例患者(6只眼),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。
[Abstract]:PurposeTo observe the clinical effect of photodynamic therapy (PDT) and transpupillary thermotherapy (TTT) in the treatment of isolated choroidal hemangioma (CCHs).Method12 eyes of 12 patients with CCH were treated with TTT.The best corrected visual acuity (BCVA) was observed before and after treatment, the changes of tumor body under ophthalmoscope were observed by color photograph of the fundus, the size and height of the tumor were examined by B-ultrasound or color Doppler, the changes of serous subretinal effusion were detected by optical coherence tomography (OCT).Fluorescein angiography and indocyanine green angiography were used to evaluate the leakage and complications.ResultAfter treatment, subretinal serous effusion disappeared, color Doppler ultrasound showed atrophy, retina flat, and blood flow negative.Fluorescein angiography combined with indocyanine green angiography showed that the fluorescein leakage of the tumor was reduced, and the macula and serous retinal detachment were completely flattened by optical coherence tomography.The postoperative visual acuity was improved, stable, and decreased in 6 eyes of 6 patients treated with TTT. The ocular fundus observation showed atrophic scar, organization, hyperpigmentation or pigment deficiency.After partial vascular occlusion. PDT treatment, 6 eyes of 6 patients, the visual acuity improved 66.7, the visual acuity stabilized 33. 3, no visual acuity decreased, the tumor atrophy was white, the light pigment disorder, and the normal retinal and choroidal blood vessels were not damaged by the observation of the fundus of the eyes, there was no damage to the normal blood vessels of the retina and choroid.ConclusionBoth TTT and PDT can make the tumor atrophy and promote the exudation and absorption, but the damage of PDT to the normal tissue of the fundus is obviously smaller than that of PDT, so it is more safe.
【学位授予单位】：中国医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R773

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