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577nm 亚阈值微脉冲激光治疗急性中心性浆液性脉络膜视网膜病变:一项对照研究。

577 nm subthreshold micropulse laser treatment for acute central serous chorioretinopathy: a comparative study.

机构信息

Wuhan Aier Eye Hanyang Hospital, Wu Han, China.

出版信息

BMC Ophthalmol. 2022 Mar 5;22(1):105. doi: 10.1186/s12886-022-02330-0.

Abstract

BACKGROUND

To assess the efficacy of 577 nm subthreshold micropulse laser (SML) treatment for acute central serous chorioretinopathy (CSC).

METHODS

This retrospective comparative case-series included 34 eyes of 34 patients with acute CSC who received either 577 nm SML treatment (SML group, n = 16 eyes) or were only monitored (observation group, n = 18 eyes). Acute CSC was defined as disease course < 3 months. Eyes with any history of treatment in the past were excluded. Data were collected over a period of 6 months. The best corrected visual acuity (BCVA), central macular thickness (CMT), and subfoveal choroidal thickness (SFCT) were observed.

RESULTS

SML group showed significantly greater improvement in the BCVA (logMAR) compared to observation group at 1 month (0.20 ± 0.10 vs 0.30 ± 0.12, P < 0.01), 3 months (0.13 ± 0.06 vs 0.21 ± 0.06, P < 0.01) and 6 months (0.01 ± 0.06 vs 0.09 ± 0.66, P < 0.01). The CMT reduction was significantly greater in the SML group at 1 month (337.19 ± 62.96 µm vs 395.11 ± 91.30 µm, P < 0.05), 3 months (312.94 ± 49.50 µm vs 364.50 ± 70.30 µm, P < 0.05) and 6 months (291.38 ± 26.46 µm vs 348.56 ± 54.65 µm, P < 0.05). In the SML group, the SFCT did not show a significant decrease at 1 month (468.88 ± 42.19 µm, P > 0.05) but showed a significant reduction at 3 months (451.75 ± 39.36 µm, P < 0.05) and 6 months (450.50 ± 34.24 µm, P < 0.05) from baseline (489.94 ± 45.86 µm). In the observation group, there was no significant change in SFCF during follow-up. No adverse events occurred in the SML group.

CONCLUSIONS

Although some patients with acute CSC show spontaneous healing, timely intervention with 577 nm SML can shorten the disease course, improve visual acuity, and reduce the risk of chronic transformation without adverse events.

摘要

背景

评估 577nm 亚阈微脉冲激光(SML)治疗急性中心性浆液性脉络膜视网膜病变(CSC)的疗效。

方法

本回顾性对照病例系列研究纳入了 34 例急性 CSC 患者的 34 只眼,这些患者接受了 577nm SML 治疗(SML 组,n=16 只眼)或仅接受了监测(观察组,n=18 只眼)。急性 CSC 的定义为病程<3 个月。排除过去有任何治疗史的患者。研究数据收集时间为 6 个月。观察最佳矫正视力(BCVA)、中心黄斑厚度(CMT)和中心凹下脉络膜厚度(SFCT)的变化。

结果

SML 组在治疗后 1 个月(0.20±0.10 比 0.30±0.12,P<0.01)、3 个月(0.13±0.06 比 0.21±0.06,P<0.01)和 6 个月(0.01±0.06 比 0.09±0.66,P<0.01)时的 BCVA(logMAR)改善均显著大于观察组。在治疗后 1 个月(337.19±62.96µm 比 395.11±91.30µm,P<0.05)、3 个月(312.94±49.50µm 比 364.50±70.30µm,P<0.05)和 6 个月(291.38±26.46µm 比 348.56±54.65µm,P<0.05)时,SML 组的 CMT 降低也显著大于观察组。在 SML 组中,SFCT 在治疗后 1 个月(468.88±42.19µm,P>0.05)时没有显著下降,但在治疗后 3 个月(451.75±39.36µm,P<0.05)和 6 个月(450.50±34.24µm,P<0.05)时较基线水平(489.94±45.86µm)显著下降。在观察组中,随访期间 SFCT 没有明显变化。SML 组未发生不良事件。

结论

虽然一些急性 CSC 患者会自发愈合,但及时采用 577nm SML 干预可以缩短病程,提高视力,并降低慢性转化的风险,且无不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bc7/8898420/1ff4687d0ca9/12886_2022_2330_Fig1_HTML.jpg

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