Müller Bert, Tatsios Janina, Klonner Jan, Pilger Daniel, Joussen Antonia M
Department of Ophthalmology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Graefes Arch Clin Exp Ophthalmol. 2018 Sep;256(9):1581-1588. doi: 10.1007/s00417-018-4031-8. Epub 2018 Jun 6.
To evaluate the efficacy of navigated focal laser photocoagulation in patients with chronic central serous chorioretinopathy (CSCR) and active leakage on fluorescein angiography (FA).
Thirty-two eyes of 32 patients (age 48 ± 11, m/f = 24/8) with persistent or recurrent CSCR (> 3 months) who received navigated laser photocoagulation (Navilas®) of leaking point(s) between June 2013 and 2016 were included in this retrospective case series. Outcome parameters after 4 weeks and 3 months were the number of patients presenting with complete resolution of subretinal fluid, the volume of subretinal fluid measured on SD-OCT (Spectralis Heidelberg Engineering©), and best corrected visual acuity (BCVA/ (Snellen equivalent).
Complete resolution of subretinal fluid was achieved in 17 eyes (50%) after 4 weeks and in 24 eyes (75%) after 3 months with an average number of 1.3 laser procedures (range 1-3). Five eyes displayed a nearly complete resolution with a reduction of over 80% of the subretinal fluid compared to baseline. Three eyes showed no reduction in subretinal fluid. BCVA improved from median 0.58 (range 0.16-1.25) to 0.66 (0.16-1.0) (p = 0.001). The seven patients who had been treated within the central 1 mm of the ETDRS-OCT Grid but outside the avascular foveal zone showed an improvement of BCVA from median 0.6 (range 0.2-1.0) to 0.8 (0.2-1.0). No patient experienced a treatment-induced visual loss.
Laser treatment with Navilas® using eye tracking and FA-based planning is a safe and effective alternative therapy in patients with chronic CSCR.
评估导航式聚焦激光光凝术对慢性中心性浆液性脉络膜视网膜病变（CSCR）患者及荧光素血管造影（FA）显示有活动性渗漏的疗效。
本回顾性病例系列纳入了2013年6月至2016年期间32例（年龄48±11岁，男/女 = 24/8）持续性或复发性CSCR（>3个月）患者的32只眼，这些患者接受了对渗漏点的导航式激光光凝术（Navilas®）。4周和3个月后的结果参数包括视网膜下液完全消退的患者数量、光谱域光学相干断层扫描（SD-OCT，Spectralis Heidelberg Engineering©）测量的视网膜下液体积以及最佳矫正视力（BCVA/（Snellen等效值））。
4周后17只眼（50%）视网膜下液完全消退，3个月后24只眼（75%）视网膜下液完全消退，平均激光治疗次数为1.3次（范围1 - 3次）。5只眼显示几乎完全消退，与基线相比视网膜下液减少超过80%。3只眼视网膜下液未减少。BCVA从中位数0.58（范围0.16 - 1.25）提高到0.66（0.16 - 1.0）（p = 0.001）。在ETDRS - OCT网格中心1mm范围内但在无血管黄斑区之外接受治疗的7例患者，BCVA从中位数0.6（范围0.2 - 1.0）提高到0.8（0.2 - 1.0）。没有患者出现治疗引起的视力丧失。
使用Navilas®并基于眼动追踪和FA进行规划的激光治疗是慢性CSCR患者一种安全有效的替代治疗方法。
