Matsumoto Hidetaka, Hoshino Junki, Nakamura Kosuke, Ohyama Yoshiaki, Morimoto Masahiro, Mukai Ryo, Sumiyoshi Hisako, Nakamura Tetsuya, Kishi Shoji, Akiyama Hideo
Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Clinical Investigation and Research Unit, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Jpn J Ophthalmol. 2023 Mar;67(2):156-163. doi: 10.1007/s10384-023-00976-x. Epub 2023 Feb 3.
To investigate the efficacy and safety of quadrant laser photocoagulation to ameliorate the choroidal congestion in central serous choroidopathy (CSC).
Historically controlled study.
We prospectively studied 20 eyes with acute CSC in the quadrant laser group, in which laser photocoagulation was applied to the macular leakage point(s) as well as the quadrant of the fundus showing vortex vein dilatation. Central choroidal thickness (CCT), vertical diameter of dilated vortex vein, resolution rate of serous retinal detachment (SRD), and visual field were evaluated post-treatment. We also compared the results with those of 18 retrospectively analyzed eyes with acute CSC in an external control group, in which laser photocoagulation had been applied only to the macular leakage point(s).
In the quadrant laser group, 2 eyes were excluded from data analysis due to choroidal neovascularization (CNV). CCT was significantly reduced in both groups, but more significantly in the quadrant laser group. The vertical diameter of the dilated vortex vein was significantly decreased only in the quadrant laser group. The resolution rate of SRD was similar in the two groups. In the quadrant laser group, 8 eyes (44.4%) showed mild deterioration of the visual field, consistent with the area subjected to quadrant laser photocoagulation.
Quadrant laser photocoagulation can have limited efficacy for ameliorating vortex vein congestion in CSC. When laser photocoagulation to the macular area is combined with quadrant laser photocoagulation, attention must be paid to the possible development of CNV and visual field deterioration.
探讨象限激光光凝改善中心性浆液性脉络膜视网膜病变（CSC）脉络膜充血的疗效和安全性。
历史对照研究。
我们前瞻性研究了象限激光组的20例急性CSC患者的眼睛，其中激光光凝应用于黄斑渗漏点以及显示涡静脉扩张的眼底象限。治疗后评估中心脉络膜厚度（CCT）、扩张涡静脉的垂直直径、浆液性视网膜脱离（SRD）的消退率和视野。我们还将结果与外部对照组中18例回顾性分析的急性CSC患者的眼睛进行了比较，该组仅对黄斑渗漏点进行了激光光凝。
在象限激光组中，2只眼因脉络膜新生血管（CNV）被排除在数据分析之外。两组的CCT均显著降低，但象限激光组更显著。仅象限激光组扩张涡静脉的垂直直径显著减小。两组SRD的消退率相似。在象限激光组中，8只眼（44.4%）出现轻度视野恶化，与接受象限激光光凝的区域一致。
象限激光光凝改善CSC中涡静脉充血的疗效有限。当黄斑区激光光凝与象限激光光凝联合应用时，必须注意CNV和视野恶化的可能发生。
