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目的观察经瞳孔温热疗法(TTT)治疗三种眼内良性肿瘤的疗效。方法通过最佳矫正视力、眼压、视野、眼前节和眼底检查以及彩色眼底照相、荧光素钠和吲哚青绿血管造影、B型超声、光相干断层扫描(OCT)、CT等检查确诊的眼内良性肿瘤患者17例20只眼。男12例,女5例,右眼8只,左眼12只。其中,视盘血管瘤3例3只眼,平均视力为0.17,2只眼曾行手术放液;脉络膜血管瘤9例9只眼,平均视力为0.39,其中4例为首诊病例,5只眼曾做过激光光凝治疗,肿瘤未全平复,尚有浆液性视网膜脱离;脉络膜骨瘤5例8只眼,平均视力为0.20,其中3只眼合并黄斑出血。TTT用810nm半导体红外激光,光斑3.0mm,按肿物大小连接照射1~5个光斑。功率360~1200mW,时间60~80s。1~3次为1疗程,2次治疗之间间隔时间1个月;需要时再作1疗程治疗。治疗后定期随访观察,时间为3~36个月,平均随访时间14.5个月。结果随访结束时平均视力,视盘血管瘤患者为0.27,脉络膜血管瘤患者为0.46,脉络膜骨瘤患者为0.31。视盘血管瘤3只眼瘤体的红色部位缩小,表面纡曲扩张的血管变平直,视盘周围出现脉络膜萎缩弧,视网膜下浆液性渗出消失。脉络膜血管瘤9只眼瘤体透红光区消失,视网膜下积液消退,治疗区色素增生。脉络膜骨瘤8只眼中视网膜下积液吸收,肿瘤颜色由黄红变为黄白,并出现色素和薄的瘢痕,合并黄斑出血者出血消失。所有患眼治疗后未出现严重并发征。结论TTT治疗视盘血管瘤、脉络膜血管瘤和脉络膜骨瘤,无论首次接受治疗或补充以前治疗均获一定效果。
Objective To observe the efficacy of transpupillary thermotherapy (TTT) in the treatment of three intraocular benign tumors. Methods The best corrected visual acuity, intraocular pressure, visual field, anterior segment and fundus examination, color fundus photography, sodium fluorescein and indocyanine green angiography, B ultrasound, coherence tomography (OCT) and CT 17 patients with benign tumor in 20 eyes. There were 12 males and 5 females, 8 right eyes and 12 left eyes. Among them, 3 cases of optic disc hemangioma in 3 cases, the average visual acuity was 0.17, 2 eyes had surgery drainage; choroidal hemangioma in 9 cases 9 eyes, the average visual acuity was 0.39, of which 4 cases were the first case, 5 eyes had Have done laser photocoagulation treatment, the tumor is not fully recovered, there are serous retinal detachment; choroidal osteoma 5 cases 8 eyes, average visual acuity of 0.20, of which 3 eyes with macular hemorrhage. TTT with 810nm semiconductor infrared laser, spot 3.0mm, according to the size of the tumor connected 1 to 5 spots. Power 360 ~ 1200mW, time 60 ~ 80s. 1 to 3 times for a course of treatment, 2 times between treatment intervals of 1 month; need to be treated once again for a course of treatment. Regular follow-up after treatment, time is 3 to 36 months, the average follow-up time of 14.5 months. Results At the end of follow-up, mean visual acuity was 0.27 in patients with optic disc hemangiomas, 0.46 in patients with choroidal hemangiomas, and 0.31 in patients with choroidal osteoma. 3 cases of optic disc hemangioma red part of the tumor shrinks, the surface of the dilated blood vessels flattened flat, choroidal atrophy arc around the optic disc, subretinal serous effusion disappeared. Choroidal hemangioma 9 eyes of the tumor disappeared through the red zone, subretinal effusion subsided, the treatment area hyperpigmentation. Choroidal osteoma 8 eyes subretinal fluid absorption, tumor color from yellow to yellow and white, and the pigment and thin scar, merger macular hemorrhage disappeared. No serious complications occurred after all eyes were treated. Conclusion TTT treatment of optic disc hemangioma, choroidal hemangioma and choroidal osteoma, regardless of the first treatment or supplement before the treatment had some effect.