Işık Mehmed Uğur, Değirmenci Mehmet Fatih Kağan, Sağlık Ayhan
Department of Ophthalmology, Kastamonu University Faculty of Medicine, Kastamonu 37100, Turkey.
Department of Ophthalmology, Çankırı State Hospital, Çankırı 18800, Turkey.
Int J Ophthalmol. 2020 Sep 18;13(9):1404-1410. doi: 10.18240/ijo.2020.09.11. eCollection 2020.
To evaluate the efficacy and safety of subthreshold micropulse yellow laser (SMYL) in the treatment of chronic central serous chorioretinopathy (CCSC).
The medical records of 58 eyes of 58 patients with CCSC were reviewed. A 577-nm SMYL system was used for the treatment. Fundus fluorescein angiography was used as the primary method of identifying CCSC, and resolution of subretinal fluid (SRF) evaluated by optical coherence tomography (OCT) and fundus autofluorescence. Central macular thickness (CMT), central macular volume (CMV), total macular volume (TMV), subfoveal choroidal thickness (SFCT), subretinal fluid height (SRFH), and subfoveal fluid basement diameter values were measured by spectral domain-OCT (SD-OCT) for all eyes.
The mean age of the patients was 42.4±9.9 (range: 20-72)y. The mean follow-up was 11.4±8.5 (range: 6-37)mo. Median BCVA at at the final follow up after treatment was statistically significant from the baseline. Complete SRF resolution was 12.1% of the eyes in the 1 month, 67.2% of the eyes in the 3 month and 67.2% of the eyes in the last follow up. The initial median CMT, CMV, TMV, and SFCT values before treatment was significantly higher than 3 month visit values (<0.001). In the multivariate analysis performed, age and disease duration were found to be a risk factor for persistent SRF (=0.017, =0.016, respectively).
SMYL treatment provides a significant anatomical and functional improvement and is effective in eliminating SRF in eyes with CCSC.
评估阈下微脉冲黄色激光（SMYL）治疗慢性中心性浆液性脉络膜视网膜病变（CCSC）的疗效和安全性。
回顾58例CCSC患者58只眼的病历。采用577nm的SMYL系统进行治疗。眼底荧光血管造影作为诊断CCSC的主要方法，通过光学相干断层扫描（OCT）和眼底自发荧光评估视网膜下液（SRF）的消退情况。使用光谱域光学相干断层扫描（SD-OCT）测量所有患眼的中心黄斑厚度（CMT）、中心黄斑体积（CMV）、总黄斑体积（TMV）、黄斑中心凹下脉络膜厚度（SFCT）、视网膜下液高度（SRFH）以及黄斑中心凹下液性暗区直径值。
患者的平均年龄为42.4±9.9（范围：20 - 72）岁。平均随访时间为11.4±8.5（范围：6 - 37）个月。治疗后末次随访时的最佳矫正视力（BCVA）中位数与基线相比有统计学意义。1个月时完全消退SRF的患眼占12.1%，3个月时占67.2%，末次随访时占67.2%。治疗前初始CMT、CMV、TMV和SFCT值的中位数显著高于3个月随访时的值（<0.001）。在进行的多因素分析中，发现年龄和病程是持续性SRF的危险因素（分别为=0.017，=0.016）。
SMYL治疗可显著改善解剖结构和功能，对消除CCSC患眼中的SRF有效。
