| Backgroud and Object: TTT (transpupillary thermotherapy) is an interesting study problem because it is an effective treatment method for choroidal neovascularization due to several choroidoretinal diseases.But its true functive mechonic and detailed parameter is still needed to founded.This animal experimental aim is to study the microscopic tissue structure change -. biologic effect -, retinochoroidal vascular form change of transpupillary thermotherapy (TTT) ,and provided instructive and theoretical evidence for its clinical practice. The aim of the clinical trial is to evaluate the effect of transpupillary thermotherapy(TTT) for the treatment of choroidal neovascularisation(CNV) in the senile macular degeneration (SMD) and central excudative choroidoretinitis (CEO .l.The Animal Experiment Study of Transpupillary ThermotherapyMethod:Four Belgium gray rabbits were used in our experimented ,of three was used to detected the chorioretinal tissue change and heat shock proteinTO (HSP70) . Another one was used to observer the form change of the vascular of choroidoretinal by the FFA and ICG after TTT 24 hours and the fundus was observed by the color camera after 24 hours -. one week -. 2 weeks - three weeks .TTT was performed on the right eye using 810nm diode laser installed slit lamp (spot size,1.2mm;duration,60 seconds;power 100mW, 80mW, 60mW) after the rabbits were anesthetized .A series of laser pulses were aimed at the posterior of the retinal and under the lower edge of the myelinated nerve fibers.The left eyes are used as the control.Twenty-four hours after laser irradiation,the histological study was performed on the chorioretinal layers.The eyes arefixed in formalin and embedded in paraffin.Retina structure were further identified by heamatoxylin erythrosine saffron (HE) coloration, Light microscope observer the choroidoretinal microscope structure. .A monoclonal antibody was used to detected heat shock protein ( HSP ) 70 immunoreactivity , followed by a biotinylated goat anti-mouse antibody ,revealed by the avidin-biotin complex and the 3-amino-9-ethyl-carbazole( AEC ) chromogen.ResultrThe photocoagulation threshold was found to be at the lOOmW .When laser irritation was end ,the retina turned hoariness .After 24 hours ,the fundus laser spots appeared edema. The ICG can found choriodal vascular emblolized and FFA csn found retina pigment epidium leakage, After 4 weeks , pigment epidium proliferated as mottled on the irridiated area,HE staining color appeared full -thickness retinal vacuolizatlon alterations along with changes in the RPE and choroids. HSP70 immunostaining was little round the laser spots of choroid. The medium dose ( 80mW ) had little gray color alteration.After 24 hours ,the laser spots turned little edema ,FFA and ICGA appeared the choroidal capillary partly emblolized and leakage. HE can found minimal outer retinal changes in the area corresponding to TTT treatment spots, more prominent changes in the outer and middle layers. Choroidal capillary emblolized by red blood cell .And the HSP70 immunostaining was the strongest at this power ,with staining of some choroidal cells ,including capillary endothelial cells ,No HSP70 were observed on the retina. The low dose was applied there was no color alteration when TTT treatment ending,after 24 hours also there was no color change.Histopathologic alterations were not seen on light microscopy , but HSP70 was detected in the RPE cells.Conclusion: When the irridiated spots are hoariness change,choriodal vascular emblolized,vacularization invovled all the retina,HSP70 immunostaining appeared at the edge of the spots.when the spots changed gray,choriodal litlle vascular is emblolized,and photoacceptor outer swollen,HSP70 immunostainsting are strongest .when the spots is no changed,no any tissue structure change can be found,and HSP70 imminostaining is only specialized in the RPE cells.2. The Clinic Study of Transpupillary ThermotherapyMethod : Retrospective, no case selective, self-contrast. A total 46 eyes of 41 patients w...
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