阈下微脉冲激光光凝对慢性中心性浆液性脉络膜视网膜病变的疗效分析
发布时间：2018-10-12 13:49
【摘要】：目的观察577 nm阈下微脉冲激光治疗慢性中心性浆液性脉络膜视网膜病变(CSC)疗效及对黄斑色素密度的影响。设计回顾性病例系列。研究对象2015年8月至2016年2月在南方医科大学武汉临床医学院确诊为慢性CSC行577 nm阈下微脉冲激光治疗的患者32例(32眼)。方法患者均行最佳矫正视力(BCVA)、全视网膜镜、眼底彩色照相及黄斑色素密度(MPOD)、荧光素眼底血管造影(FFA)和吲哚菁绿血管造影(ICGA)、相干光断层扫描(OCT)及对比敏感度检查。577 nm阈下微脉冲激光治疗光斑直径100μm,曝光时间0.2 s,负载系数5%,治疗能量为50%P,根据检查结果对渗漏点及其周围(跨出渗漏点约50~100μm)进行覆盖性光凝。治疗后1、3、6个月复查相关检查。主要指标BCVA、视网膜中心凹厚度(CFT)和对比敏感度、视网膜下液(SRF)吸收率、预后相关因素及黄斑色素密度。结果治疗1、3、6个月后BCVA分别为0.36±0.15、0.35±0.16、0.32±.021,均较前好转(P均0.05);CFT分别为(305.56±62.53)μm、(298.29±46.42)μm、(253.81±57.18)μm,均较前下降(P均0.05);对比敏感度分别为14.32±1.02、15.68±0.98、17.53±1.32,均较前提高(P均0.05)。阈下微脉冲治疗慢性CSC疗效与病变类型和年龄相关,当病变为点状渗漏其SRF吸收率最高为100%,病变为局限性渗漏伴RPE萎缩时SRF吸收率为72.73%,当病变为弥漫性病变及RPE萎缩时SRF吸收率最低为64.25%。阈下微脉冲治疗慢性CSC无反应组平均年龄高于有反应组(t=-9.23,P=0.001)。随访6个月,所有患者所有检查上均未在治疗部位观察到可见光斑。阈下微脉冲激光治疗后1、3、6个月MPOD平均值分别为0.15±0.18、0.16±0.05、0.16±0.21(P均0.05)。结论 577 nm阈下微脉冲激光治疗慢性CSC安全有效,对MPOD水平无影响。
[Abstract]:Objective to observe the effect of 577 nm subthreshold micropulse laser on chronic central serous chorioretinopathy (CSC) and its effect on macular pigment density. Design retrospective case series. Participants from August 2015 to February 2016, 32 patients (32 eyes) with chronic CSC were treated with 577 nm subthreshold micro-pulse laser in Wuhan College of Clinical Medicine, Southern Medical University. Methods all patients were treated with best corrected visual acuity (BCVA),). Fundus color photography and macular pigment density (MPOD), fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA), coherence tomography (OCT) and contrast sensitivity. 577 nm subthreshold micropulse laser treatment of spot diameter 100 渭 m, exposure time 0.2 s, load coefficient 5 and the therapeutic energy 50 g / P, the percolation point and its surroundings (about 50 ~ 100 渭 m across the leakage point) were covered with photocoagulation according to the results of the examination. At 1: 3 and 6 months after treatment, the related examinations were re-examined. Main outcome measures BCVA, retinal foveal thickness (CFT) contrast sensitivity (SRF) absorptivity of subretinal fluid prognostic factors and macular pigment density. Results BCVA was 0.36 卤0.15 卤0.35 卤0.16 卤0.32 卤0.21, respectively, which was better than that before treatment (P 0.05); CFT was (305.56 卤62.53) 渭 m, (298.29 卤46.42) 渭 m, (253.81 卤57.18) 渭 m, respectively, and the contrast sensitivity was 14.32 卤1.02 卤15.68 卤0.9817.53 卤1.32, respectively). The effect of subthreshold micropulse therapy on chronic CSC was correlated with the type of lesion and age. The SRF absorptivity was 100 when the lesion was point leakage, 72.73 when the lesion was localized leakage with RPE atrophy, and the lowest SRF absorptivity was 64.25when the lesion was diffuse and RPE atrophy. The average age of chronic CSC patients treated with subthreshold micropulse was higher than that of patients with chronic CSC (tr-9. 23 P0. 001). All the patients were followed up for 6 months. No visible spot was observed on all examinations. The mean value of MPOD was 0.15 卤0.18 卤0.05 卤0.16 卤0.16 卤0.21 at 3 and 6 months after subthreshold micro-pulse laser treatment respectively (P 0.05). Conclusion 577 nm subthreshold micropulse laser is safe and effective in the treatment of chronic CSC, and has no effect on the level of MPOD.
【作者单位】： 南方医科大学武汉临床医学院;
【基金】：国家自然科学基金(61378084)
【分类号】：R774.1
本文编号：2266353
[Abstract]:Objective to observe the effect of 577 nm subthreshold micropulse laser on chronic central serous chorioretinopathy (CSC) and its effect on macular pigment density. Design retrospective case series. Participants from August 2015 to February 2016, 32 patients (32 eyes) with chronic CSC were treated with 577 nm subthreshold micro-pulse laser in Wuhan College of Clinical Medicine, Southern Medical University. Methods all patients were treated with best corrected visual acuity (BCVA),). Fundus color photography and macular pigment density (MPOD), fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA), coherence tomography (OCT) and contrast sensitivity. 577 nm subthreshold micropulse laser treatment of spot diameter 100 渭 m, exposure time 0.2 s, load coefficient 5 and the therapeutic energy 50 g / P, the percolation point and its surroundings (about 50 ~ 100 渭 m across the leakage point) were covered with photocoagulation according to the results of the examination. At 1: 3 and 6 months after treatment, the related examinations were re-examined. Main outcome measures BCVA, retinal foveal thickness (CFT) contrast sensitivity (SRF) absorptivity of subretinal fluid prognostic factors and macular pigment density. Results BCVA was 0.36 卤0.15 卤0.35 卤0.16 卤0.32 卤0.21, respectively, which was better than that before treatment (P 0.05); CFT was (305.56 卤62.53) 渭 m, (298.29 卤46.42) 渭 m, (253.81 卤57.18) 渭 m, respectively, and the contrast sensitivity was 14.32 卤1.02 卤15.68 卤0.9817.53 卤1.32, respectively). The effect of subthreshold micropulse therapy on chronic CSC was correlated with the type of lesion and age. The SRF absorptivity was 100 when the lesion was point leakage, 72.73 when the lesion was localized leakage with RPE atrophy, and the lowest SRF absorptivity was 64.25when the lesion was diffuse and RPE atrophy. The average age of chronic CSC patients treated with subthreshold micropulse was higher than that of patients with chronic CSC (tr-9. 23 P0. 001). All the patients were followed up for 6 months. No visible spot was observed on all examinations. The mean value of MPOD was 0.15 卤0.18 卤0.05 卤0.16 卤0.16 卤0.21 at 3 and 6 months after subthreshold micro-pulse laser treatment respectively (P 0.05). Conclusion 577 nm subthreshold micropulse laser is safe and effective in the treatment of chronic CSC, and has no effect on the level of MPOD.
【作者单位】： 南方医科大学武汉临床医学院;
【基金】：国家自然科学基金(61378084)
【分类号】：R774.1
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