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中心性浆液性脉络膜视网膜病变中视网膜下液的短期存在影响视网膜厚度和功能。

Short Term Presence of Subretinal Fluid in Central Serous Chorioretinopathy Affects Retinal Thickness and Function.

作者信息

Gawęcki Maciej, Jaszczuk Agnieszka, Grzybowski Andrzej

机构信息

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

Department of Ophthalmology, University of Warmia and Mazury, 10-719 Olsztyn, Poland.

出版信息

J Clin Med. 2020 Oct 26;9(11):3429. doi: 10.3390/jcm9113429.

Abstract

Acute central serous chorioretinopathy (CSCR), with subretinal fluid (SRF) resolving spontaneously within a few months from disease onset, has been considered as a benign and self-limiting disease for many years. This study sought to discover if a short presence of SRF can result in morphological and functional damage to the retina. The study included patients treated by subthreshold diode micropulse laser (SDM) application for acute CSCR at the Dobry Wzrok Ophthalmological Clinic between January 2018 and November 2019. Inclusion criteria were: first episode of CSCR; duration of symptoms of two months or less; complete resolution of subretinal fluid (SRF) after a single session of SDM; and a lack of any retinal pathology, previous CSCR episode, significant anisometropia or amblyopia in the collateral eye. Fifteen patients fulfilled the inclusion criteria, including 13 males and two females aged 42.3 ± 9.5 years. The mean duration of symptoms before treatment was 4.7 ± 1.3 weeks on average. Baseline and follow-up examinations were performed in both the affected and collateral eyes and included best-corrected visual acuity (BCVA); spectral-domain optical coherent tomography measurements such as central retinal thickness (CRT) and minimal foveal thickness (MFT) (at the follow-up visit only); fluorescein angiography (at presentation only) and fundus autofluorescence. The first follow-up visit, when the total resolution of SRF was noted, was conducted between 8 and 12 weeks after SDM. Resolved CSCR eyes had significantly poorer BCVA, CRT, and MFT findings in comparison with healthy collateral eyes (respectively, 0.11 +/- 0.1 vs. 0.01 +/- 0.04 logMAR; 238.80 +/- 23.39 vs. 264.87 +/- 21.22 µm and 178.93 +/- 16.88 vs. 199.47 +/- 17.87 µm) despite the short period of CSCR duration (maximum of 14 ± 2.15 weeks on average). Short presence of SRF typical for acute CSCR can affect retinal function and morphology resulting in poorer visual outcome.

摘要

急性中心性浆液性脉络膜视网膜病变(CSCR)的视网膜下液(SRF)在疾病发作后的几个月内会自发消退,多年来一直被认为是一种良性的自限性疾病。本研究旨在探究SRF的短暂存在是否会导致视网膜的形态和功能损伤。该研究纳入了2018年1月至2019年11月期间在多布里·兹罗克眼科诊所接受阈下二极管微脉冲激光(SDM)治疗急性CSCR的患者。纳入标准为:CSCR首次发作;症状持续时间为两个月或更短;单次SDM治疗后视网膜下液(SRF)完全消退;以及患眼不存在任何视网膜病变、既往CSCR发作史、显著屈光参差或弱视。15名患者符合纳入标准,包括13名男性和2名女性,年龄为42.3±9.5岁。治疗前症状的平均持续时间为4.7±1.3周。对患眼和对侧眼均进行了基线和随访检查,包括最佳矫正视力(BCVA);光谱域光学相干断层扫描测量,如视网膜中央厚度(CRT)和最小黄斑厚度(MFT)(仅在随访时测量);荧光素血管造影(仅在就诊时进行)和眼底自发荧光。在SDM治疗后8至12周进行了首次随访,此时记录到SRF完全消退。尽管CSCR持续时间较短(平均最长为14±2.15周),但与健康对侧眼相比,已消退的CSCR患眼的BCVA、CRT和MFT结果明显较差(分别为0.11±0.1对0.01±0.04 logMAR;238.80±23.39对264.87±21.22 µm以及178.93±16.88对199.47±17.87 µm)。急性CSCR典型的SRF短暂存在会影响视网膜功能和形态,导致较差的视觉预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a57/7692782/26d62d72a46e/jcm-09-03429-g001.jpg

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