Newsom R S, McAlister J C, Saeed M, McHugh J D
King's College Hospital, Denmark Hill, London SE5 9RS, UK.
Br J Ophthalmol. 2001 Feb;85(2):173-8. doi: 10.1136/bjo.85.2.173.
To assess the effectiveness of transpupillary thermotherapy (TTT) for the treatment of classic and occult choroidal neovascularisation (CNV).
In a retrospective, case selected, open label trial 44 eyes of 42 patients with CNV secondary to age related macular degeneration (ARMD) were studied. 44 eyes with angiographically defined CNV were treated with diode laser (810 nm) TTT. Laser beam sizes ranged between 0.8 and 3.0 mm and power settings between 250-750 mW. Treatment was given in one area for 1 minute, the end point being no visible change, or a slight greying of the retina. Outcome was assessed with Snellen visual acuity and clinical examination; in 24/44 patients angiographic follow up was available.
12 predominantly classic CNV and 32 predominantly occult membranes were followed up for a mean of 6.1 months (range 2-19). Mean change in vision for classic membranes was -0.75 (SD 1.75) Snellen lines and occult membranes was -0.66 Snellen lines (2.1) (p>0.05). Predominantly classic membranes were closed in 75% (95% CI: 62.5-87.5) of eyes, remained persistent in 25% (95% CI: 12.5-37.5); no recurrences occurred. Predominantly occult membranes were closed in 78% (95% CI: 70.1-85.3) of eyes, remained persistent in 12.5% (95% CI: 6.6-18.5), and were recurrent in 5.1% (95% CI: 4.2-14.3).
Transpupillary thermotherapy is a potential treatment for CNV. It is able to close choroidal neovascularisation while maintaining visual function in patients with classic and occult disease. Further trials of TTT are needed to compare this intervention with the natural history and other treatment modalities.
评估经瞳孔温热疗法（TTT）治疗典型性和隐匿性脉络膜新生血管（CNV）的有效性。
在一项回顾性、病例选择、开放标签试验中，对42例年龄相关性黄斑变性（ARMD）继发CNV患者的44只眼进行了研究。对44只经血管造影确诊的CNV眼进行了二极管激光（810nm）TTT治疗。激光束大小在0.8至3.0mm之间，功率设置在250 - 750mW之间。在一个区域治疗1分钟，终点为无可见变化或视网膜轻微发灰。通过Snellen视力和临床检查评估结果；44例患者中有24例可进行血管造影随访。
12只主要为典型性CNV和32只主要为隐匿性脉络膜新生血管膜的患者平均随访6.1个月（范围2 - 19个月）。典型性脉络膜新生血管膜的平均视力变化为-0.75（标准差1.75）Snellen视力行，隐匿性脉络膜新生血管膜为-0.66 Snellen视力行（2.1）（p>0.05）。主要为典型性脉络膜新生血管膜的眼中75%（95%置信区间：62.5 - 87.5）闭合，25%（95%置信区间：12.5 - 37.5）持续存在；无复发。主要为隐匿性脉络膜新生血管膜的眼中78%（95%置信区间：70.1 - 85.3）闭合，12.5%（95%置信区间：6.6 - 18.5）持续存在，5.1%（95%置信区间：4.2 - 14.3）复发。
经瞳孔温热疗法是CNV的一种潜在治疗方法。它能够闭合脉络膜新生血管，同时维持典型性和隐匿性疾病患者的视觉功能。需要进一步进行TTT试验，以将这种干预措施与自然病程及其他治疗方式进行比较。
