Verma Lalit, Sinha Rajesh, Venkatesh Pradeep, Tewari H K
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
BMC Ophthalmol. 2004 Oct 29;4:15. doi: 10.1186/1471-2415-4-15.
To evaluate the efficacy of diode laser photocoagulation in patients with central serous retinopathy (CSR) and to compare it with the effects of argon green laser.
Thirty patients with type 1 unilateral CSR were enrolled and evaluated on parameters like best corrected visual acuity (BCVA), direct and indirect ophthalmoscopy, amsler grid for recording scotoma and metamorphopsia, contrast sensitivity using Cambridge low contrast gratings and fluorescein angiography to determine the site of leakage. Patients were randomly assigned into 2 groups according to the statistical random table using sequence generation. In Group 1 (n = 15), diode laser (810 nm) photocoagulation was performed at the site of leakage while in Group 2 (n = 15), eyes were treated with argon green laser (514 nm) using the same laser parameters. Patients were followed up at 4, 8 and 12 weeks after laser.
The mean BCVA in group 1 improved from a pre-laser decimal value of 0.29 +/- 0.14 to 0.84 +/- 0.23 at 4 weeks and 1.06 +/- 0.09 at 12 weeks following laser. In group 2, the same improved from 0.32 +/- 0.16 to 0.67 +/- 0.18 at 4 weeks and 0.98 +/- 0.14 at 12 weeks following laser. The improvement in BCVA was significantly better in group 1 (p < 0.0001) at 4 weeks. At 4 weeks following laser, all the patients in group1 were free of scotoma while 6 patients in group 2 had residual scotoma (p < 0.05). The mean contrast sensitivity in group 1 improved from pre-laser value of 98.4 +/- 24.77 to 231.33 +/- 48.97 at 4 weeks and 306.00 +/- 46.57 at 12 weeks following laser. In group 2, the same improved from 130.66 +/- 31.95 to 190.66 +/- 23.44 at 4 weeks and 215.33 +/- 23.25 at 12 weeks. On comparative evaluation, a significantly better (p < 0.001) improvement was noted in group 1.
Diode laser may be a better alternative to argon green laser whenever laser treatment becomes indicated in patients with central serous retinopathy in terms of faster visual rehabilitation and better contrast sensitivity. In addition, diode laser also has the well-recognized ergonomic and economic advantages.
评估二极管激光光凝术治疗中心性浆液性视网膜病变（CSR）患者的疗效，并与氩绿激光的效果进行比较。
纳入30例单侧1型CSR患者，对其最佳矫正视力（BCVA）、直接和间接检眼镜检查、用于记录暗点和视物变形的阿姆斯勒方格表、使用剑桥低对比度光栅的对比敏感度以及荧光素血管造影以确定渗漏部位等参数进行评估。根据统计随机表采用随机序列生成法将患者随机分为2组。第1组（n = 15）在渗漏部位进行二极管激光（810 nm）光凝术，第2组（n = 15）使用相同的激光参数用氩绿激光（514 nm）治疗眼睛。在激光治疗后4周、8周和12周对患者进行随访。
第1组的平均BCVA从激光治疗前的小数视力值0.29±0.14在激光治疗后4周提高到0.84±0.23，在12周时提高到1.06±0.09。第2组的平均BCVA从激光治疗前的0.32±0.16在激光治疗后4周提高到0.67±0.18，在12周时提高到0.98±0.14。第1组在4周时BCVA的改善明显更好（p < 0.0001）。激光治疗后4周，第1组所有患者均无暗点，而第2组有6例患者有残留暗点（p < 0.05）。第1组的平均对比敏感度从激光治疗前的值98.4±24.77在激光治疗后4周提高到231.33±48.97，在12周时提高到306.00±46.57。第2组的平均对比敏感度从激光治疗前的130.66±31.95在激光治疗后4周提高到190.66±23.44，在12周时提高到215.33±23.25。经比较评估，第1组的改善明显更好（p < 0.001）。
就更快的视力恢复和更好的对比敏感度而言，当中心性浆液性视网膜病变患者需要进行激光治疗时，二极管激光可能是氩绿激光的更好替代方法。此外，二极管激光还具有公认的人体工程学和经济优势。
