Hirayama Kumiko, Yamamoto Manabu, Kohno Takeya, Kyo Akika, Theisen-Kunde Dirk, Brinkmann Ralf, Miura Yoko, Honda Shigeru
Department of Ophthalmology and Visual Science, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Medical Laser Center Lübeck, Lübeck, Germany.
Graefes Arch Clin Exp Ophthalmol. 2021 Feb;259(2):387-393. doi: 10.1007/s00417-020-04931-1. Epub 2020 Sep 22.
Tilted disc syndrome (TDS) may be associated with a macular serous retinal detachment (MSRD). However, ideal therapy for this complication is still unestablished yet to date. The purpose of this study is to investigate the effect of selective retina therapy (SRT) for MSRD associated with TDS.
This retrospective study included 11 eyes of 10 patients (1 male and 9 females), who were treated with SRT for MSRD associated with TDS, and observed at least 12 months after treatment. The mean age was 56 years old (range 44-66). An SRT laser (527 nm, 1.7 μs, 100 Hz; Medical Laser Center Lübeck, Germany) was used for treatment. The changes of best-corrected visual acuity (BCVA), central macular thickness (CMT), and central choroidal thickness (CCT) were examined. Subfoveal curve height (SFCH) was calculated at baseline.
The mean follow-up period was 24.4 months (range 12-48 months). The mean BCVA (logMAR), CMT, and CCT changed from 0.03 ± 0.10, 324 ± 82 μm, and 194 ± 68 μm preoperatively to 0.07 ± 0.17, 274 ± 94 μm, and 188 ± 65 μm at final follow-up, respectively, with significant difference on CMT (BCVA: p = 0.44, CMT: p < 0.05, CCT: p = 0.21). The MSRD disappeared in 6 eyes (55%) and the average number of SRT irradiations until resolution of MSRD was 2.6 times (range 1-5 times). There was no significant association between SFCH and resolution of MSRD (p = 0.19).
SRT may promote absorption of MSRD and maintenance of BCVA for TDS. Randomized and prospective clinical studies are needed to evaluate the effectiveness of SRT for MSRD associated with TDS.
倾斜盘综合征（TDS）可能与黄斑部浆液性视网膜脱离（MSRD）相关。然而，针对这种并发症的理想治疗方法至今仍未确立。本研究的目的是探讨选择性视网膜治疗（SRT）对与TDS相关的MSRD的疗效。
本回顾性研究纳入了10例患者（1例男性和9例女性）的11只眼，这些患者因与TDS相关的MSRD接受了SRT治疗，并在治疗后至少观察12个月。平均年龄为56岁（范围44 - 66岁）。使用SRT激光（527 nm，1.7 μs，100 Hz；德国吕贝克医学激光中心）进行治疗。检查最佳矫正视力（BCVA）、中心黄斑厚度（CMT）和中心脉络膜厚度（CCT）的变化。在基线时计算黄斑中心凹下曲线高度（SFCH）。
平均随访期为24.4个月（范围12 - 48个月）。平均BCVA（logMAR）、CMT和CCT分别从术前的0.03±0.10、324±82μm和194±68μm变为末次随访时的0.07±0.17、274±94μm和188±65μm，CMT有显著差异（BCVA：p = 0.44，CMT：p < 0.05，CCT：p = 0.21）。6只眼（55%）的MSRD消失，MSRD消退前SRT照射的平均次数为2.6次（范围1 - 5次）。SFCH与MSRD的消退之间无显著相关性（p = 0.19）。
SRT可能促进与TDS相关的MSRD的吸收并维持BCVA。需要进行随机和前瞻性临床研究来评估SRT对与TDS相关的MSRD的有效性。
