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急性中心性浆液性脉络膜视网膜病变的早期局灶性激光光凝:一项前瞻性随机研究

Early Focal Laser Photocoagulation in Acute Central Serous Chorioretinopathy: A Prospective, Randomized Study.

作者信息

Ambiya Vikas, Khodani Mitali, Goud Abhilash, Narayanan Raja, Tyagi Mudit, Rani Padmaja Kumari, Chhablani Jay

出版信息

Ophthalmic Surg Lasers Imaging Retina. 2017 Jul 1;48(7):564-571. doi: 10.3928/23258160-20170630-07.

Abstract

BACKGROUND AND OBJECTIVE

To evaluate the role of early focal laser photocoagulation in acute central serous chorioretinopathy (CSC).

PATIENTS AND METHODS

A total of 58 eyes with acute naïve CSC (less than 2 months' duration) with focal leak on fundus fluorescein angiography (FFA) were randomized into either a laser or a sham laser group. Eyes with chronic CSC and subfoveal leak were excluded. Visual acuity assessment, microperimetry, optical coherence tomography, and FFA were done at baseline, 1 month (minus FFA), 3 months, and 6 months after treatment.

RESULTS

There was a significant improvement in best-corrected visual acuity, low-contrast visual acuity, retinal sensitivity, and central macular thickness at all visits in both groups (P < .001); however, there was no significant difference between the groups regarding time of resolution. Four eyes in the sham laser group needed rescue laser compared with one eye in early laser group (P = .16).

CONCLUSION

Early laser photocoagulation is not superior to sham laser for acute CSC; therefore, observation appears to the safest and most effective strategy. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:564-571.].

摘要

背景与目的

评估早期局灶性激光光凝在急性中心性浆液性脉络膜视网膜病变(CSC)中的作用。

患者与方法

共有58只患有急性初发性CSC(病程小于2个月)且眼底荧光血管造影(FFA)显示有局灶性渗漏的眼睛被随机分为激光治疗组或假激光治疗组。排除患有慢性CSC和黄斑中心凹下渗漏的眼睛。在治疗前基线、治疗后1个月(不包括FFA)、3个月和6个月进行视力评估、微视野检查、光学相干断层扫描和FFA检查。

结果

两组在所有随访时最佳矫正视力、低对比度视力、视网膜敏感度和黄斑中心厚度均有显著改善(P <.001);然而,两组在视力恢复时间方面无显著差异。假激光治疗组有4只眼睛需要补救性激光治疗,而早期激光治疗组有1只眼睛需要补救性激光治疗(P = 0.16)。

结论

对于急性CSC,早期激光光凝并不优于假激光治疗;因此,观察似乎是最安全且最有效的策略。[《眼科手术、激光与视网膜成像》。2017年;48:564 - 571。]

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