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目的:吲哚青绿(indocyannine green,ICG)的吸收峰(805nm)与810nm半导体激光波长相近,使其可成为治疗脉络膜血管瘤的光敏剂,该方法被称为吲哚青绿ICG介导的光栓疗法(indocyannine green mediated photothrombosis,IMP)。为了探讨IMP治疗脉络膜血管瘤的效果,我们对8例(8眼)限局性脉络膜血管瘤进行了治疗。方法:将2mL ICG溶液通过肘前静脉快速注射,使用IRIS810nm半导体激光器于注射后3min对瘤体进行照射。参数:光斑直径3.0~9.0mm,功率450~1300mW,照射时间60s。用同样参数于ICG注射后20min进行第二次激光照射。随访时间6~24mo(平均8.15mo),通过视力、直接眼底镜、海德堡共焦眼底血管造影仪(heidelberg retina angio-graph,HRA)实施的眼底荧光素血管造影(fundus fluore-seein angiography,FFA)及吲哚青绿血管造影(indocyan-nine green angiograph,ICGA)观察治疗效果,用HeidelbergEye Explore软件测量治疗前后瘤体面积的变化。结果:至最后一次随访,经IMP治疗的8眼的血管瘤面积较治疗前均缩小(100%),患眼矫正视力提高>2行以上者有2眼(25%),视力提高>1行以上者有3眼(38%),视力无变化者3眼(38%)。视力提高的5眼注视性暗影及视物变形等症状有程度不同的改善。结论:本研究结果显示,IMP对脉络膜血管瘤有一定治疗效果,该方法安全、经济。但有关IMP的治疗参数、远期疗效及并发症等问题还需更大样本的长期临床观察。
OBJECTIVE: The absorption peak of indocyanine green (ICG) (805 nm) is similar to the wavelength of 810 nm semiconductor laser, making it an photosensitizer for the treatment of choroidal hemangiomas. This method is referred to as indocyanine green ICG-mediated photoperiod Indocyanine green mediated photothrombosis (IMP). To investigate the effect of IMP on choroidal hemangiomas, we treated 8 patients (8 eyes) with localized choroidal hemangiomas. Methods: 2mL ICG solution was rapidly injected through the antecubital vein and the tumor was irradiated 3min after injection with IRIS810nm semiconductor laser. Parameters: Spot diameter 3.0 ~ 9.0mm, power 450 ~ 1300mW, irradiation time 60s. The second laser irradiation was performed 20 minutes after ICG injection with the same parameters. The follow-up time ranged from 6 to 24 months (mean, 8.15 months). Fundus fluore-seein angiography (FFA) was performed by visual acuity, direct ophthalmoscopy and Heidelberg retina angio-graph (HRA) And indocyan-nine green angiograph (ICGA). The HeidelbergEye Explore software was used to measure the change of tumor area before and after treatment. RESULTS: At the final follow-up, the area of hemangiomas in 8 eyes treated with IMP had been reduced (100%) compared with that before treatment, and 2 eyes (25%) had eyes with an improvement in visual acuity of> 2 or more and visual acuity> 1 There were 3 eyes (38%) of the above and 3 eyes (38%) of the eyes without change. Visual acuity of five eyes, such as attention and visual distortion and other symptoms have varying degrees of improvement. Conclusion: The results of this study show that IMP has a certain therapeutic effect on choroidal hemangioma, which is safe and economical. However, the treatment parameters of IMP, long-term efficacy and complications and other issues need more samples of long-term clinical observation.