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題名:循血綠眼底攝影指引雷射治療老年性黃斑部變性之中心窩外境界不明的脈絡膜新生血管     (20點)
INDOCYANINE GREEN ANGIOGRAPHY-GUIDED LASER PHOTOCOAGULATION TREATMENT OF EXTRAFOVEAL OCCULT CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION
著者:楊昌叔(Chang-Sue Yang) ;李鳳利(Fenq-Lih Lee) ;林嘉理(Chia-Lee Lin) ;許紋銘(Wen-Wing Hsu) ;劉榮宏(Jorn-Hon Liu)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:Age-related Macular Degeneration ; Fluorescein Angiography ; Indocyanine Green Angiography ; Laser Photocoagulation ; Occult Choroidal Neovascularization
刊名:中華民國眼科醫學會雜誌
卷期:39卷3期(2000.9)
頁碼:247-256
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

背景:循血綠眼底攝影{Indocyanine green (ICG) angiography}對診斷老年性黃斑部變性(age-related macular degeneration, ARMD)的脈絡膜新生血管(choroidal neovascularization, CNV)的偵測和精確定位上,確實比傳統螢光眼底血管攝影(fluorescein angiography, FA)更有幫助。本篇研究的目的,是藉循血綠眼底攝影指引來雷射治療黃斑中心窩外的境界不明新生血管(extrafoveal occult CNV),評估其臨床治療效果。 方法:收集滲出型老年性黃斑部變性病例,採用掃描雷射眼底鏡(scanning laser ophthalmoscope, SLO)來實行循血錄眼底血管攝影。選擇符合雷射治療的脈絡膜新生血管是引用傳統的雷射準則,在循血綠攝影下呈境界分明的點或盤狀過螢光(focal or plaque hyper-fluorescence),位置在黃斑中心窩外。採用氬氣雷射治療,術後定期複查循血綠眼底攝影,以早期發現殘留或再發新生血管(Persistent or recurrent CNV),並立刻重複雷射。 結果:合計21眼有黃斑中心窩外境界不明的脈絡膜新生血管接受雷射治療,病人追蹤期平約為13個月。雷射治療後眼底外觀上結果(anatomic outcome),眼底病灶完全緩解有10眼(48%),部份緩解有5眼(24%),治療後無反應或惡化有6眼(28%)。雷射術後病人最終視力結果(visual outcome),有進步二行或以上的有5眼(24%),能維持視力穩定的有12眼(57%),視力惡化有4眼(19%)。雷射治療後完全或部份緩解的,新生血管再復發的有8眼(53%, 8/15)。 結論:本篇初步研究結果顯示,藉循血綠眼底攝影指引,對境界不明的黃斑中心窩外脈絡膜新生血管,雷射治療後,大部分病眼在眼底病灶及視力上皆有進步或達到穩定,證明是臨床上可行的治療方法。這初步研究有持將來大規模、對照研究來進一步證實其臨床應用價值。
Background. Indocyanine green (ICG) angiography increased the detection and delineation of poorly-defined or occult choroidal neovascularization (CNV) when compared with fluorescein angiography. We conducted this study to evaluate the efficacy of ICG angiography-guided laser photocoagulation of extrafoveal occult CNV in age-related macular degeneration (ARMD). Methods. The authors performed ICG angiography with scanning laser ophthalmoscope (SLO) in eyes with exudative ARMD. Patients were selected for laser treatment, using conventional guidelines, when ICG angiography demonstrated a well-delineated area of focal or plaque hyper-fluorescence, presumed to be choroidal neovascularization. Argon laser photocoagulation treatment was applied under ICG angiography guidance. Follow-up ICG angiography was performed to allow early detection of the persistent or recurrent CNV after laser therapy, if present, repeated laser treatment was applied. Results. There were 21 patients (21 eyes) who had extrafoveal occult CNV receiving argon laser treatment under ICG angiography guidance. The anatomic outcome showed complete resolution in 10 eyes (48%), partial resolution in 5 eyes (24%), no change or worse in 6 eyes (28%). Visual outcome was improved in 5 eyes (24%), stabilization of vision in 12 eyes (57%) and worse in 4 eyes (19%). Mean follow up period was 13 months. The recurrence of CNV after laser therapy was noted in 8 eyes (53%). Conclusion. Our preliminary study showed that ICG angiography-guided laser treatment can produce visual outcome improvement or stabilization in many cases of extrafoveal occult CNV in ARMD. Further control studies and longer follow-up are necessary to confirm the efficacy of this modality of therapy.


    

本卷期目次
中華民國眼科醫學會雜誌 39卷3期 (2000.9)
視網膜血管阻塞性病變/ 林嘉理
Macular Degeneration/ 李鳳利;整理:林欣怡
THE CLINICAL COURSE AND VISUAL MANAGEMENT OF CONGENITAL MYOPIA/ Yi-Hui ChiangLuke L-K. LinChong-Bin TsaiTzyy-Chang HoYung-Feng ShihPor T. Hung
THE EFFECT OF TROPICAMIDE VERSUS ATROPINE ON THE REFRACTIVE ERRORS OF MYOPIC CHILDREN/ Yi-Chien YangLin-Chung WoungHui-Hsin ChiangJeen-Hon JianYung-Feng Shih
循血綠眼底攝影指引雷射治療老年性黃斑部變性之中心窩外境界不明的脈絡膜新生血管/ 楊昌叔李鳳利林嘉理許紋銘劉榮宏
以接觸式二極體雷射經鞏膜睫狀體光凝固術治療頑抗性青光眼/ 林彥君張雪麗吳秀琛許慶堂
電腦Farnsworth-Munsell氏100-Hue色覺檢查程式及其臨床應用-初報/ 廖旭彬宋湖仙古婉珍
戴安全帽對視野的影響/ 王順弘蔡武甫
以傻瓜相機探測斜視之研究/ 沈秉衡曾崇彥
SERRATIA MARCESCENS CORNEAL ULCER-COMPLICATIONS OF ORTHOKERATOLOGY-A CASE REPORT/ Tung-Mei KuangKo-Hwa ChenTse-Hsiang YehChih-Chiau WuShui-Mei LeeWen-Ming HsuJorn-Hon Liu
IRIDOSCHISIS DEMONSTRATED BY ULTRASOUND BIOMICROSCOPY IN A PATIENT WITH VOGT-KOYANAGI-HARADA SYNDROME--CASE REPORT/ Elizabeth P. ShenChang-Ping LinWei-Lun LanPor T. HungPing-Kang Hou
OPTIC NEURITIS RELATED TO CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY-A CASE REPORT/ Der-Chong TsaiPo-Kang LinKon-Ping LinKo-Pei KaoJorn-Hon Liu
GENOTYPIC DRIFT OF MITOCHONDRIAL DNA IN A PATIENT WITH LEBER'S HEREDITARY OPTIC NEUROPATHY/ May-Yung YenJorn-Hon LiuYau-Huei Wei
蜜峰螫傷角膜-病例報告/ 林正明蔡宜佑
羊膜應用於濾泡滲漏的修補術-病例報告/ 王文正蔡宜倫郭麗琳
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同側半盲和威而剛-病例報告/ 黃峻峰鄭俊彥林清澤
多發輝閃性白點症候群-12病例報告/ 黃舜平林伯剛李安斐張由美許紋銘劉榮宏
FROSTED BRANCH ANGIITIS病例報告/ 詹維鈞陳立仁
高壓氣體引起的創傷性眼眶氣腫/ 郭麗君林建廷林正明蔡宜佑
 
   
 
   

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