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导航激光光凝治疗非消退性和慢性中心性浆液性脉络膜视网膜病变患者。

Navigated laser photocoagulation in patients with non-resolving and chronic central serous chorioretinopathy.

作者信息

Müller Bert, Tatsios Janina, Klonner Jan, Pilger Daniel, Joussen Antonia M

机构信息

Department of Ophthalmology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2018 Sep;256(9):1581-1588. doi: 10.1007/s00417-018-4031-8. Epub 2018 Jun 6.

Abstract

PURPOSE

To evaluate the efficacy of navigated focal laser photocoagulation in patients with chronic central serous chorioretinopathy (CSCR) and active leakage on fluorescein angiography (FA).

METHODS

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).

RESULTS

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.

CONCLUSIONS

Laser treatment with Navilas® using eye tracking and FA-based planning is a safe and effective alternative therapy in patients with chronic CSCR.

摘要

目的

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。

方法

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))。

结果

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。

结论

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。

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