ABSTRACT
Objective To investigate the approach and effect of PDT and TTT therapeutic alliance for isolated choroidal angioma according to the lication. Methods After mydriasis,through 90D retinal mirror examination ,fluorescein fundus angiography (FFA) ,Indocyanine green angiography (ICGA) and ultrasound,the diagnosis of angiography choroidsal hemangioma was made. Position:peripapillary , six cases( tumors locating only in macula fovea were not included in this statistical area). OCT suggested that epithetlial tumors from the surface of nerve macular were affected. Period of the disease was between one week and two months . Preoperative best corrected vision acuity range was 1. 05 ～ 0.4. By ultrasonography, tumors thickenss was from 2.2mm to 4mm, and diameter was from 6.6mm to 11.2mm. OCT indicated that the height of neural epithetlium breaking away from macular area was between 156mm and 486mm. inferior retinas separated two months after morbidity. TTT was partly applied to cure tumor body ortside macdular area with IRIS Medical OculightSLX gallium arsenicde laser(810nm). Energy:per light spot shining diameter was 1 mm, and the power was between 150mw to 250mW, and time was 60s. Therapeutic standard was retinal surface changing to pale. Choroids shrunk back and retinal ptgment epithetlium prolixferated in TTT therapy area;recheck 2 weeks later. If FFA showed that active macula fovea pathological changes were not cured, PDT was performed as following :689nm laser was used , and veteporfin ( comm. ercial name : Visudyne) was injected by intravenous at a speed of 6mg/mm~2 , and 15 minutes later, the laser was irradiated for a period of 83 ～ 126s. For tumors with thicdness under 3mm,one light spot was irradiated for 83s;for rumors with thicdness above 3mm, acouple light apot was irradiated for 125s. A small quantity of hyperpigmintation occurred in the limbus,luteus retinae at the second week of follow up. All the cases were followed up for 3 months to 12 months. Results The final vision reached 0.1 ～ 1.0. OCT showed that the earliest complete recovery of limbus luteus retinae neural epithetlium was at the third week, and for another 3 cases,the recovery was at the 4th week. One case with detachment of retina partial recovered 3 months after treatment. OCT suggested that most of the macular detachment and epithetlial cystic degenerateion of neurons recovered to normal. type - B ultrasound was performed in the first three months of treatment. The tumors were difficult to be detected in two cases, and four cases had a thickness of 0. 8 ～2.2mm. At the 6th month,the detection of tumors for the six cases showed normal results. PDT was used only once in the included six cases. Conclusion PDT and TTT therapeutic alliance for isolated choroidsal angioma is safe and effective at special position of eye ground. Each treatment showed its unlque adventages in this combination with a reduction of frequentcy and cost of expensive cost of PDT, and satisfying results of the shrink of the rumors and improvement or preservation of vision.