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经阈下微脉冲激光治疗的慢性中心性浆液性脉络膜视网膜病变患者的功能和形态学转归

Functional and morphological outcome in patients with chronic central serous chorioretinopathy treated by subthreshold micropulse laser.

作者信息

Gawęcki Maciej, Jaszczuk-Maciejewska Agnieszka, Jurska-Jaśko Anna, Grzybowski Andrzej

机构信息

Dobry Wzrok Ophthalmological Clinic, Kliniczna 1B/2, 80-402, Gdańsk, Poland.

Chair of Ophthalmology, University of Warmia and Mazury, Warszawska 30, 10-082, Olsztyn, Poland.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2017 Dec;255(12):2299-2306. doi: 10.1007/s00417-017-3783-x. Epub 2017 Aug 22.

Abstract

BACKGROUND

Chronic central serous chorioretinopathy is a serious therapeutic problem as it may lead to significant visual impairment. The aim of this retrospective study is to evaluate functional and morphological effects, as well as factors influencing visual outcome in patients treated by subthreshold micropulse laser.

METHODS

Fifty-one eyes with chronic central serous chorioretinopathy lasting longer than 4 months (18 months on average) underwent up to two sessions of subtreshold micropulse laser treatment. Change in best corrected visual acuity, central retinal thickness, central retinal volume, average central retinal thickness and maximum subretinal fluid height were measured. Relation between the effects of the treatment and the initial retinal morphological and functional parameters was then analyzed.

RESULTS

The total resorption of subretinal fluid was achieved in 36 cases (70.6%). There was, however, only a minor improvement in best corrected visual acuity of approximately one line on the Snellen chart. No correlation was observed between the effects of the treatment and the duration of the symptoms, retinal morphology and initial visual acuity. Younger patients responded better to the therapy.

CONCLUSION

Subthreshold micropulse laser treatment in chronic serous chorioretinopathy provides good morphological results, however significant improvement of visual acuity is not to be expected.

摘要

背景

慢性中心性浆液性脉络膜视网膜病变是一个严重的治疗难题,因为它可能导致明显的视力损害。这项回顾性研究的目的是评估阈下微脉冲激光治疗患者的功能和形态学效果,以及影响视力预后的因素。

方法

51只患有慢性中心性浆液性脉络膜视网膜病变且病程超过4个月(平均18个月)的眼睛接受了最多两次阈下微脉冲激光治疗。测量最佳矫正视力、中心视网膜厚度、中心视网膜体积、平均中心视网膜厚度和最大视网膜下液高度的变化。然后分析治疗效果与初始视网膜形态和功能参数之间的关系。

结果

36例(70.6%)实现了视网膜下液的完全吸收。然而,最佳矫正视力仅在Snellen视力表上有大约一行的轻微改善。未观察到治疗效果与症状持续时间、视网膜形态和初始视力之间的相关性。年轻患者对治疗反应更好。

结论

慢性浆液性脉络膜视网膜病变的阈下微脉冲激光治疗可提供良好的形态学结果,但视力的显著改善难以预期。

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