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光学相干断层扫描参数作为 577nm 亚阈值微脉冲激光治疗慢性中心性浆液性脉络膜视网膜病变疗效的预测指标。

Optical coherence tomography parameters as predictors of treatment response to a 577-nm subthreshold micropulse laser in chronic central serous chorioretinopathy.

机构信息

Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital, Saglik Bilimleri University, 34752, Istanbul, Turkey.

出版信息

Lasers Med Sci. 2021 Sep;36(7):1505-1514. doi: 10.1007/s10103-020-03225-6. Epub 2021 Jan 7.

DOI:10.1007/s10103-020-03225-6
PMID:33409750
Abstract

To determine the relation between retinal microstructural changes and the response to 577-nm subthreshold micropulse laser (SML) treatment in chronic central serous chorioretinopathy (cCSC). This retrospective study included 39 eyes of 39 patients with cCSC, treated with the 577-nm SML. The eyes were evaluated in three groups: complete remission, partial remission, and failure groups. The presence of some baseline retinal microstructural changes, thickness of the outer nuclear layer (ONL), status of the ellipsoid zone (EZ), and retinal pigment epithelium (RPE) were evaluated. The changes in central macular thickness (CMT), subretinal fluid (SRF) height, and best-corrected visual acuity (BCVA) were calculated. There were 14, 13, and 12 eyes in the complete remission, partial remission, and failure group, respectively. The baseline EZ and RPE were found intact in 71.4% and 64.3% of the eyes in the complete remission group, respectively; however, these rates were respectively 25% and 16.7% in the failure group (p < 0.05). Extrafoveal foci were present in 35.7% of the eyes in the complete remission group, but none was found in the failure group (p < 0.05). Although there was no statistically significant difference, the baseline ONL thickness was higher, and the hyperreflective dots, retinal bumps, subretinal fibrinous exudates, and PEDs were seen less in the complete remission group. The changes of the BCVA were not significant in any of the groups at the last visit (p > 0.05). The presence of baseline intact EZ and RPE, and extrafoveal foci can potentially be used as predictors of the SML treatment success in cCSC.

摘要

目的

探讨慢性中心性浆液性脉络膜视网膜病变(cCSC)患者视网膜微观结构变化与 577nm 亚阈微脉冲激光(SML)治疗反应之间的关系。

方法

本回顾性研究纳入了 39 例(39 只眼)接受 577nm SML 治疗的 cCSC 患者。根据治疗后随访结果将患者分为完全缓解组、部分缓解组和未缓解组。分析比较各组间基线视网膜微观结构变化、外核层(ONL)厚度、椭圆体带(EZ)完整性和视网膜色素上皮(RPE)完整性,计算并比较各组中心视网膜厚度(CMT)、视网膜下液(SRF)高度和最佳矫正视力(BCVA)的变化。

结果

完全缓解组、部分缓解组和未缓解组分别有 14、13 和 12 只眼。完全缓解组中 EZ 和 RPE 完整的比例分别为 71.4%和 64.3%,未缓解组中这两项的比例分别为 25%和 16.7%,差异有统计学意义(p<0.05)。完全缓解组中有 35.7%的眼存在旁中心区病灶,而未缓解组中无一例存在(p<0.05)。完全缓解组的基线 ONL 厚度较高,且高反射点、视网膜隆突、视网膜下纤维渗出和 PED 较少,但这些差异均无统计学意义。末次随访时各组间 BCVA 的变化均无统计学意义(p>0.05)。

结论

基线 EZ 和 RPE 完整、存在旁中心区病灶可能有助于预测 cCSC 患者 SML 治疗的效果。

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