Ohashi Hirokazu, Oh Hideyasu, Nishiwaki Hirokazu, Nonaka Atsushi, Takagi Hitoshi
Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Ophthalmology. 2004 Nov;111(11):2050-6. doi: 10.1016/j.ophtha.2004.04.031.
To study the detailed process of macular edema (ME) absorption after grid laser photocoagulation in patients with branch retinal vein occlusion (BRVO). The influence of pretreatment serous retinal detachment (SRD) at the fovea on patient outcome was also evaluated.
Retrospective, interventional, comparative case series.
Thirty-seven BRVO patients presenting with severe ME.
Patients were treated with grid laser photocoagulation with 6 months of follow-up examinations. Baseline and post-treatment examinations included measurements of visual acuity (VA), fluorescein angiography, and detailed imaging of ME by optical coherence tomography (OCT). Macular thickness was defined as the distance from the inner retinal surface to the outer border of the sensory retina (foveal retinal thickness) and also to the inner border of the retinal pigment epithelium including the SRD (total foveal elevation).
Post-treatment macular thickness with OCT, VA converted to the logarithm of the minimum angle of resolution, and absorption of SRD, and correlations of macular thickness and VA both before and after treatment.
Total foveal elevation and VA were significantly improved at 1, 3, and 6 months after treatment. There was also a significant correlation between reduction of total foveal elevation and increase in VA. Fourteen eyes (37.8%) displayed SRD, as evidenced by OCT at the baseline. In eyes without SRD, foveal retinal thickness and VA had significantly improved in a time-dependent manner. However, although SRD itself was almost absorbed 6 months after treatment, the improvement of both VA and total foveal elevation in eyes with pretreatment SRD was not significant compared with baseline conditions. Both post-treatment total foveal elevation and VA of eyes with SRD tended to be worse than eyes without SRD.
The presence of subfoveal SRD retards the absorption of ME and recovery of VA after grid laser photocoagulation in patients with BRVO.
研究视网膜分支静脉阻塞（BRVO）患者行格栅样激光光凝术后黄斑水肿（ME）吸收的详细过程。同时评估黄斑中心凹处治疗前浆液性视网膜脱离（SRD）对患者预后的影响。
回顾性、干预性、对比病例系列研究。
37例患有严重ME的BRVO患者。
对患者进行格栅样激光光凝治疗，并进行为期6个月的随访检查。基线检查和治疗后检查包括视力（VA）测量、荧光素血管造影以及通过光学相干断层扫描（OCT）对ME进行详细成像。黄斑厚度定义为从视网膜内表面到感觉视网膜外边界（黄斑视网膜厚度）以及到包括SRD在内的视网膜色素上皮内边界的距离（黄斑总隆起）。
治疗后用OCT测量的黄斑厚度、转换为最小分辨角对数的VA、SRD的吸收情况，以及治疗前后黄斑厚度与VA的相关性。
治疗后1个月、3个月和6个月时，黄斑总隆起和VA均有显著改善。黄斑总隆起的降低与VA的增加之间也存在显著相关性。14只眼（37.8%）在基线OCT检查时有SRD表现。在没有SRD的眼中，黄斑视网膜厚度和VA随时间显著改善。然而，尽管治疗6个月后SRD本身几乎完全吸收，但与基线情况相比，治疗前有SRD的眼中VA和黄斑总隆起的改善并不显著。有SRD的眼治疗后的黄斑总隆起和VA均往往比没有SRD的眼更差。
黄斑中心凹下SRD的存在会延缓BRVO患者行格栅样激光光凝术后ME的吸收和VA的恢复。
