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年龄相关性黄斑变性患者经瞳孔温热疗法治疗典型和隐匿性脉络膜新生血管28个月后的结果

Results 28 months following transpupillary thermotherapy for classic and occult choroidal neovascularization in patients with age-related macular degeneration.

作者信息

Newsom R S B, McAlister J C, Saeed M, El-Ghonemy K, McHugh J D A

机构信息

King's College Hospital, London, United Kingdom.

出版信息

Ophthalmic Surg Lasers Imaging. 2005 Mar-Apr;36(2):94-102.

Abstract

BACKGROUND AND OBJECTIVE

To report the outcome of patients 28 months following treatment with transpupillary thermotherapy (TTT) for classic and occult choroidal neovascularization (CNV) secondary to age-related macular degeneration.

PATIENTS AND METHODS

A nonrandomized pilot trial of 36 eyes of 33 patients was performed. Eyes with angiographically defined CNV, 11 predominantly classical and 25 predominantly occult, were treated with large spot diode laser (810 nm) TTT for 1 minute, the end point being no or minimal visible change. Outcome was assessed with best-corrected LogMAR visual acuity, clinical examination, and fluorescein angiography.

RESULTS

Patients were observed for a mean of 28.7 months (range, 18 to 40 months). The mean change in LogMAR visual acuity for predominantly classic membranes was -1.91 (standard deviation [SD] = 4.3) and 5 of 11 (45.5%) eyes had a loss of 3 or more LogMAR lines. Predominantly classic membranes were closed in 9 of 11 eyes and stabilized in 2 of 11 eyes. The mean change in LogMAR visual acuity for predominantly occult membranes was -1.48 (SD = 6.3) and 10 of 25 (40%) patients had a loss of 3 lines or more. Predominantly occult CNV was stabilized in 25 of 25 cases, and recurrence developed in 2 of 25 cases; one of the latter developed classic CNV.

CONCLUSIONS

The medium-term results for patients treated with TTT for both occult and classic CNV show good stability, with little visual loss and few recurrences. These data confirm the original findings of this study.

摘要

背景与目的

报告年龄相关性黄斑变性继发典型和隐匿性脉络膜新生血管(CNV)患者接受经瞳孔温热疗法(TTT)治疗28个月后的结果。

患者与方法

对33例患者的36只眼进行了一项非随机试验。血管造影显示有CNV的眼,11只主要为典型性,25只主要为隐匿性,用大光斑二极管激光(810nm)TTT治疗1分钟,终点为无可见变化或仅有轻微可见变化。通过最佳矫正LogMAR视力、临床检查和荧光素血管造影评估结果。

结果

患者平均观察28.7个月(范围18至40个月)。主要为典型性脉络膜新生血管膜的LogMAR视力平均变化为-1.91(标准差[SD]=4.3),11只眼中有5只(45.5%)视力下降3个或更多LogMAR行。11只眼中9只主要为典型性脉络膜新生血管膜封闭,2只稳定。主要为隐匿性脉络膜新生血管膜的LogMAR视力平均变化为-1.48(SD=6.3),25例中有10例(40%)视力下降3行或更多。25例中25例主要为隐匿性CNV稳定,25例中有2例复发;其中1例发展为典型CNV。

结论

TTT治疗隐匿性和典型性CNV患者的中期结果显示稳定性良好,视力丧失少,复发少。这些数据证实了本研究的最初发现。

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