CAJ | 학술논문

目的：对比观察在孤立性脉络膜血管瘤（ circumscribed choroidal hemangioma ， CCH ）的治疗中，光动力学疗法（ photodynamic therapy ， PDT ）与经瞳孔温热疗法（ transpupillary thermotherapy ， TTT ）的临床疗效。 　　方法：选取CCH患者24例24眼，应用TTT治疗12例， PDT治疗12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及并发症等。 　　结果：所有患者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伏，瘤体平复。 TTT治疗患者12例12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 治疗患者12例12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。
목적：대비관찰재고립성맥락막혈관류（ circumscribed choroidal hemangioma ， CCH ）적치료중，광동역학요법（ photodynamic therapy ， PDT ）여경동공온열요법（ transpupillary thermotherapy ， TTT ）적림상료효。 　　방법：선취CCH환자24례24안，응용TTT치료12례， PDT치료12례。관찰환안치료전후최가교정시력；안저채색조편，검안경하관찰류체변화；B초혹채색다보륵검사류체대소、고도변화；광학상간단층소묘검사장액성시망막하적액적변화；형광소혈관조영급신타정록혈관조영판단류체삼루정황급병발증등。 　　결과：소유환자경치료후안저검사균가견시망막하장액성삼출소실，채색다보륵초성시류체위축，시망막평복，혈류정음성，형광소혈관조영연합신타정록혈관조영가견류체혈관형광삼루감경，광학상간단층소묘시황반급류체장액성시망막탈리완전평복，류체평복。 TTT치료환자12례12안술후시력제고、은정、하강비례，각점33．3％；안저관찰가견류체위축반흔，궤화，대량색소증생혹색소결실，부분혈관폐새。 PDT 치료환자12례12안，시력제고자66.7％，시력은정자33．3％，무시력하강；안저관찰가견류체위축정백색，경도색소문란，시망막급맥락막정상혈관미견손해。 　　결론：TTT여PDT치료CCH，균능사류체위축병촉진삼출흡수，단PDT대안저정상조직손상명현소우TTT，구유경고적안전성。
AIM: To observe the clinical therapeutic effect of photodynamic therapy ( PDT ) and transpupillary thermotherapy ( TTT ) on circumscribed choroid hemangioma ( CCH) . METHODS: Totally 24 cases ( 24 eyes ) of CCH were selected in this study. Twelve of them had undergone TTT, and the other 12 were treated by PDT.The changes of tumors were examined by best corrected visual acuity, results of fundus photography, and direct ophthalmoscopy; the changes of tumors'sizes and heights were examined by B-ultrasound examination and coloured doppler imaging; the presence of serous subretinal fluid were examined by optical coherence tomography ( OCT ); the leakage of tumors and complications were analyzed by fluorescence fundus angiography ( FFA ) and indocyanine green angiography ( ICGA) . RESULTS: In all cases, the tumors shrinked back, the blood flows tuned negative, the fluorescence leakages lessened and the serous retinal detachments resolved completely according to OCT, FFA, ICGA and coloured doppler imaging.In the 12 patients treated by TTT, visual acuity improved in 33.3%, unchanged in 33.3%, and droped in 33.3% too; the results of fundus examinations showed obvious pigmentation and atrophy tumor with organized scar.In the 12 patients treated by PDT, visual acuity improved in 66.7%, unchanged in 33.3%, and none droped;the results of fundus examinations showed slight pigment derangement, atrophy tumor tuned white, and normal blood vessel undamaged. CONCLUSION: Both TTT and PDT can make the tumor atrophy and the exudation absorbed.Unlike TTT, PDT damages little normal tissue, and has higher security.