低能量TTT治疗中心凹下渗漏型CSC的临床研究

发布时间：2018-08-25 19:05

【摘要】：目的评价低能量经瞳孔温热疗法(transpupillary thermotherapy,TTT)治疗中心凹下渗漏型中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的效果。方法经眼底荧光血管造影(fundus fluorescein angiography,FFA)和光学相干断层扫描(optical coherence tomography,OCT)检查确诊为中心凹下渗漏型CSC患者40例(40眼),随机分为治疗组22例(22眼)和对照组18例(18眼)。治疗组采用810半导体激光进行低能量TTT治疗,对照组予口服复方血栓通胶囊和沃丽汀片。两组分别于治疗后2周、4周、8周、12周时行自觉症状(Amsler表)、最佳矫正视力(best corrected visual acuity,BCVA)、OCT检查,并于治疗后4周、12周时行FFA检查,对检查结果进行统计学分析。结果治疗后两组患者自觉症状减轻或消退,视力及视觉质量均有不同程度改善。两组在治疗后2周、4周、8周时视力提高和自觉症状改善方面进行比较,差异均有统计学意义(均为P0.05)。FFA检查治疗后4周时对照组、治疗组荧光素渗漏点完全封闭者分别为50.0%、90.9%,两组间差异有统计学意义(P0.05)。对照组治疗后2周、4周、8周黄斑中心凹厚度分别为(350±109)μm、(300±101)μm、(252±90)μm,治疗组黄斑中心凹厚度分别为(252±105)μm、(207±95)μm、(175±82)μm,荧光素渗漏点消失差异均有统计学意义(均为P0.05),而在12周时差异无统计学意义(P0.05)。治疗组在激光治疗过程及随访过程中均未发现与激光相关的的并发症以及复发,对照组有3例复发。结论低能量TTT治疗CSC安全、有效,能缩短病程,有助于保护黄斑功能,适用于中心凹下渗漏型CSC的治疗。
[Abstract]:Objective to evaluate the efficacy of low energy transpupillary thermotherapy (transpupillary thermotherapy,TTT) in the treatment of central serous chorioretinopathy (central serous chorioretinopathy,CSC) with subfoveal leakage. Methods Forty patients (40 eyes) with subfoveal leakage CSC were diagnosed by fundus fluorescein angiography (fundus fluorescein angiography,FFA) and optical coherence tomography (optical coherence tomography,OCT). They were randomly divided into treatment group (22 eyes) and control group (18 eyes). The treatment group was treated with 810 semiconductor laser for low energy TTT, while the control group was treated with compound Xueshuantong capsule and Waletine tablet. The two groups were examined by Oct at 2 weeks, 4 weeks, 8 weeks and 12 weeks after treatment, respectively. Oct and FFA were performed at 4 weeks and 12 weeks after treatment, respectively. The results were statistically analyzed. Results after treatment, the symptoms of the two groups were relieved or subsided, and the visual acuity and visual quality were improved to some extent. The difference between the two groups in visual acuity improvement and conscious symptom improvement at 2 weeks and 4 weeks and 8 weeks after treatment was statistically significant (P0.05) .FFA examination at 4 weeks after treatment in the control group. In the treatment group, the complete closure of fluorescein leakage point was 50.0% and 90.9%, respectively. The difference between the two groups was statistically significant (P0.05). In the control group, the thickness of macular fovea was (350 卤109) 渭 m, (300 卤101) 渭 m, (252 卤90) 渭 m, respectively, and the thickness of macular fovea was (252 卤105) 渭 m, (207 卤95) 渭 m, (175 卤82) 渭 m, respectively. In the treatment group, there were no laser related complications and recurrence during laser therapy and follow-up, while in the control group, 3 cases recurred. Conclusion low energy TTT is safe and effective in the treatment of CSC. It can shorten the course of disease and protect macular function. It is suitable for the treatment of CSC with subfoveal leakage.
【作者单位】：解放军第180医院眼科;
【基金】：南京军医“第十一五”医药卫生资助课题(编号:08MA083)~~
【分类号】：R774.1

【参考文献】