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急性中心性浆液性脉络膜视网膜病变发作期间和之后的视觉功能。

Visual function during and after an acute central serous chorioretinopathy episode.

机构信息

Eye Hospital, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia.

Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

出版信息

Doc Ophthalmol. 2022 Aug;145(1):27-35. doi: 10.1007/s10633-022-09875-x. Epub 2022 May 24.

DOI:10.1007/s10633-022-09875-x
PMID:35608741
Abstract

PURPOSE

To evaluate visual function parameters during and after an acute central serous chorioretinopathy (CSC) episode.

METHODS

A prospective study included 19 fovea involving acute CSC patients with episode resolution within 3 months from the episode onset. Optical coherence tomography, best corrected visual acuity (BCVA), contrast sensitivity (CS), microperimetry (MP), and multifocal electroretinography (mfERG) were performed at baseline, 3 and 6 months from the episode onset. In a sub analysis, patients were divided into groups with greater (gMV, N = 9) and lower (lMV, N = 10) macular volume at presentation, and functional outcomes were observed.

RESULTS

BCVA (p < 0.001), average CS (CS-A) (p < 0.001), average retinal sensitivity (MP-A) (p < 0.001), mfERG amplitude densities in the first and second ring (mfERG-A1, p < 0.001; mfERG-A2, p = 0.017), and implicit times in the first, second, and third ring (mfERG-IT1, p = 0.024; mfERG-IT2, p = 0.002; mfERG-IT3, p = 0.018) improved with episode resolution 3 months after the episode onset. From 3 to 6 months after the episode onset, only CS-A (p = 0.045) continued to improve. Patients in the gMV group had lower mfERG-A1 (p = 0.017) and central retinal sensitivity (MP-C, p = 0.05) 6 months from the episode onset.

CONCLUSIONS

Although all functional parameters mostly improve with CSC episode resolution, only CS continues to improve thereafter. Patients with greater MV at presentation have worse functional outcomes. Visual function impairment in acute CSC patients is confined to the topographical area of subretinal fluid detachment.

摘要

目的

评估急性中心性浆液性脉络膜视网膜病变(CSC)发作期间和之后的视觉功能参数。

方法

一项前瞻性研究纳入了 19 例累及黄斑的急性 CSC 患者,这些患者的发作在发作后 3 个月内得到解决。在基线时、发作后 3 个月和 6 个月时进行光学相干断层扫描、最佳矫正视力(BCVA)、对比敏感度(CS)、微视野(MP)和多焦视网膜电图(mfERG)检查。在亚分析中,根据病变累及黄斑的程度将患者分为黄斑体积较大(gMV,N=9)和较小(lMV,N=10)两组,并观察其功能结局。

结果

BCVA(p<0.001)、平均 CS(CS-A)(p<0.001)、平均视网膜敏感度(MP-A)(p<0.001)、第一环和第二环的 mfERG 振幅密度(mfERG-A1,p<0.001;mfERG-A2,p=0.017)以及第一、第二和第三环的 mfERG 潜时(mfERG-IT1,p=0.024;mfERG-IT2,p=0.002;mfERG-IT3,p=0.018)在发作后 3 个月随着发作的解决而改善。从发作后 3 个月到 6 个月,只有 CS-A(p=0.045)继续改善。在发作后 6 个月时,gMV 组患者的 mfERG-A1(p=0.017)和中央视网膜敏感度(MP-C,p=0.05)较低。

结论

尽管所有功能参数在 CSC 发作解决后大多得到改善,但此后只有 CS 继续改善。在发作时黄斑体积较大的患者功能结局较差。急性 CSC 患者的视力损伤局限于视网膜下积液脱离的区域。

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本文引用的文献

1
Prospective evaluation of visual acuity assessment: a comparison of snellen versus ETDRS charts in clinical practice (An AOS Thesis).视力评估的前瞻性研究:临床实践中Snellen视力表与ETDRS视力表的比较(一篇美国眼科学会论文)
Trans Am Ophthalmol Soc. 2009 Dec;107:311-24.
经黄斑中心凹阈下微脉冲激光治疗持续性中心性浆液性脉络膜视网膜病变的功能预后和安全性概况
Life (Basel). 2023 May 16;13(5):1194. doi: 10.3390/life13051194.