Shukla D, Kolluru C, Vignesh T P, Karthikprakash S, Kim R
Retina--Vitreous Service, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, TN, India.
Eye (Lond). 2008 Jan;22(1):100-6. doi: 10.1038/sj.eye.6702449. Epub 2006 May 26.
To evaluate transpupillary thermotherapy (TTT) for the treatment of subfoveal focal leaks in central serous chorioretinopathy (CSC).
The patients presenting with long-standing CSC, but without the features of chronicity, were offered the options of TTT, photodynamic therapy (for subfoveal leaks), photocoagulation (for extrafoveal leaks), or observation. The patients who opted for TTT or observation were enrolled in this study. TTT was performed using a spot diameter of 0.5 mm for 1 min. Best-corrected visual acuity (BCVA), status of macular detachment, and fluorescein angiographic status were evaluated at 1, 3, and 6 months.
This study included 39 patients (40 eyes) with CSC between 4 and 12 months, of whom 25 patients (25 eyes) opted for TTT for subfoveal leaks. Fourteen patients (15 eyes) were followed up without treatment. The groups were comparable in age, sex, and baseline BCVA. Minimum follow-up was 6 months. Within 3 months, TTT resulted in the resolution of the serous detachment in 24 (96%) eyes with a single session; one eye required a repeat treatment. Eight control eyes demonstrated persisting CSC at the last follow-up. Visual acuity improved in 23 (92%) treated and five (33%) control eyes; the difference in outcome was statistically significant (P<0.001). One case developed choroidal neovascularization, which resolved with visual recovery to 20/20 after repeat-TTT.
TTT resulted in the resolution of CSC with subfoveal angiographic leaks with significant improvement in visual outcome, in comparison to the natural history of persistent CSC.
评估经瞳孔温热疗法（TTT）治疗中心性浆液性脉络膜视网膜病变（CSC）黄斑中心凹下局限性渗漏的效果。
向患有长期CSC但无慢性特征的患者提供TTT、光动力疗法（用于黄斑中心凹下渗漏）、光凝治疗（用于黄斑中心凹外渗漏）或观察等选择。选择TTT或观察的患者纳入本研究。TTT采用光斑直径0.5mm，持续1分钟。在1、3和6个月时评估最佳矫正视力（BCVA）、黄斑脱离状态和荧光素血管造影状态。
本研究纳入了39例（40只眼）病程在4至12个月的CSC患者，其中25例（25只眼）选择TTT治疗黄斑中心凹下渗漏。14例（15只眼）患者未接受治疗进行随访。两组在年龄、性别和基线BCVA方面具有可比性。最短随访时间为6个月。在3个月内，TTT单次治疗使24只（96%）眼的浆液性脱离消退；1只眼需要重复治疗。8只对照眼在最后一次随访时CSC持续存在。23只（92%）接受治疗的眼和5只（33%）对照眼的视力得到改善；结果差异具有统计学意义（P<0.001）。1例发生脉络膜新生血管，经重复TTT后视力恢复至20/20，脉络膜新生血管消退。
与持续性CSC的自然病程相比，TTT可使黄斑中心凹下血管造影渗漏的CSC消退，视力结果有显著改善。
