亚阈值纳秒激光对中年年龄相关性黄斑变性视网膜结构和功能的影响。
Effect of subthreshold nanosecond laser on retinal structure and function in intermediate age-related macular degeneration.
机构信息
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Department of Ophthalmology, University of Bonn, Bonn, Germany.
出版信息
Clin Exp Ophthalmol. 2022 Jan;50(1):31-39. doi: 10.1111/ceo.14018. Epub 2021 Oct 24.
BACKGROUND
Subthreshold nanosecond laser (SNL) treatment has been studied as a potential intervention in intermediate age-related macular degeneration (iAMD). This study investigated the effect of 100 SNL treatment spots on retinal structure and function.
METHODS
A prospective single-arm interventional pilot study. SNL treatment was delivered as 100 spots around the retinal vascular arcades of the study eye (worst visual acuity) in a single session in subjects with iAMD. Multimodal retinal imaging and dark-adapted chromatic perimetry were performed at baseline and at 0.5, 3, 6 and 12 months post treatment. Post treatment changes in best corrected visual acuity (BCVA), retinal thickness, relative ellipsoid zone reflectivity (rEZR) and rod-mediated functional parameters were compared to baseline.
RESULTS
Twenty-one subjects with iAMD were recruited. SNL treatment was associated with an increase in retinal thickness (p = 0.008) and decrease in rEZR (p < 0.001) at 2 weeks post laser. Recovery of retinal thickness and rEZR was observed at the 3-month post laser visit. A gradual improvement in BCVA was observed after laser treatment. The mean change in BCVA between baseline and 12-month visit was +1.9 ± 3.3 letters for the SNL treated eyes, compared to -0.4 ± 3.0 letters for the fellow eyes (p = 0.027). Rod-mediated function improved at 3 months post laser (p < 0.001) and returned to the baseline levels at 12 months post treatment.
CONCLUSIONS
A single treatment with 100 SNL spots causes a short-term change in retinal structure and improvement in retinal function that are apparent at 3 months post treatment.
背景
亚阈值纳秒激光(SNL)治疗已被研究作为治疗中间年龄相关性黄斑变性(iAMD)的一种潜在干预方法。本研究调查了 100 个 SNL 治疗点对视网膜结构和功能的影响。
方法
这是一项前瞻性单臂干预性试点研究。在患有 iAMD 的受试者的研究眼中(最佳视力),在单个疗程中围绕视网膜血管弓给予 100 个 SNL 治疗点。在基线和治疗后 0.5、3、6 和 12 个月时进行多模态视网膜成像和暗适应色觉视野检查。将治疗后最佳矫正视力(BCVA)、视网膜厚度、相对椭圆区反射率(rEZR)和杆状功能参数的变化与基线进行比较。
结果
共招募了 21 名患有 iAMD 的受试者。SNL 治疗后 2 周,视网膜厚度增加(p=0.008),rEZR 降低(p<0.001)。在激光治疗后 3 个月观察到视网膜厚度和 rEZR 的恢复。激光治疗后,BCVA 逐渐改善。SNL 治疗眼在基线和 12 个月随访时的平均 BCVA 变化为+1.9±3.3 个字母,而对侧眼为-0.4±3.0 个字母(p=0.027)。激光治疗后 3 个月,杆状功能改善(p<0.001),并在治疗后 12 个月恢复到基线水平。
结论
单次 100 个 SNL 点治疗会导致视网膜结构的短期变化和视网膜功能的改善,这些变化在治疗后 3 个月时明显。