本文選題：孤立性脈絡(luò)膜血管瘤/局限性脈絡(luò)膜血管瘤 + 光動力學(xué)療法�。� 參考：《中國醫(yī)科大學(xué)》2010年碩士論文

【摘要】： 目的 觀察光動力學(xué)療法(photodynamic therapy, PDT)與經(jīng)瞳孔溫?zé)岑煼?transpupillary thermotherapy, TTT)治療孤立性脈絡(luò)膜血管瘤(circumscribed choroidal hemangioma, CCH)的臨床療效。 方法 CCH患者12例12只眼,應(yīng)用TTT治療6例,PDT治療6例。觀察患眼治療前后最佳矯正視力；眼底彩色照片,檢眼鏡下觀察瘤體變化；B超或彩色多普勒檢查瘤體大小、高度變化；光學(xué)相干斷層掃描檢查漿液性視網(wǎng)膜下積液的變化；熒光素血管造影及吲哚菁綠血管造影判斷瘤體滲漏情況；以及并發(fā)癥等。 結(jié)果 12例患者(12只眼)經(jīng)治療后眼底檢查均可見視網(wǎng)膜下漿液性滲出消失,彩色多普勒超聲示瘤體萎縮,視網(wǎng)膜平伏,血流呈陰性,熒光素血管造影聯(lián)合吲哚菁綠血管造影可見瘤體血管熒光滲漏減輕,光學(xué)相干斷層掃描示黃斑及瘤體漿液性視網(wǎng)膜脫離完全平復(fù),瘤體平復(fù)。6例TTT治療患者(6只眼)術(shù)后視力提高、穩(wěn)定、下降比例,各占33.3%;眼底觀察可見瘤體萎縮瘢痕,機(jī)化,大量色素增生或色素缺失,部分血管閉塞。PDT治療后6例患者(6只眼),視力提高者66.7%,視力穩(wěn)定者33.3%,無視力下降；眼底觀察可見瘤體萎縮呈白色,輕度色素紊亂,視網(wǎng)膜及脈絡(luò)膜正常血管未見損害。 結(jié)論 TTT與PDT治療CCH,均能使瘤體萎縮并促進(jìn)滲出吸收,但PDT對眼底正常組織損傷明顯小于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.
【學(xué)位授予單位】：中國醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R773

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