Torrellas Beatriz, Filloy Alejandro, Wu Lihteh, Chhablani Jay, Romero-Aroca Pedro
Ophtalmology Department, Joan XXIII University Hospital, 43007 Tarragona, Spain.
Institut d'Investigació Sanitaria Pere Virgili (IISPV), Rovira & Virgili University, 43204 Reus, Spain.
J Clin Med. 2023 Jan 31;12(3):1127. doi: 10.3390/jcm12031127.
The aim of this study was to evaluate the effectiveness and safety of a yellow subthreshold laser (STL) for the treatment of chronic central serous chorioretinopathy delivered in a fovea-sparing pattern and to analyze the post-laser changes in the choroidal structure by Swept-Source Optical Coherence Tomography. This study was a prospective case series of 43 eyes corresponding to 37 patients. Data were recorded at 6, 12 and 24 weeks after the STL treatment. The best-corrected visual acuity improved in 93% of the patients and remained stable in 7%. The subretinal fluid was completely reabsorbed in 27.9%, 32.6% and 69.8% of the patients at 6, 12 and 24 weeks, respectively. There were reductions in the choroidal thickness of 13.1% and 25.3% at 12 and 24 weeks, which corresponded to reductions of 17.5% and 45.9% in the choriocapillaris and Sattler layer and reductions of 12.2% and 21.2% in the Haller layer at 12 and 24 weeks, respectively ( < 0.05). This might account for the effect of the laser on the inner choroidal vasculature, the dysregulation of which is believed to be at the core of central serous chorioretinopathy. No laser-related complications were detected. Overall, the fovea-sparing STL was safe and effective in this series of patients.
本研究的目的是评估以保留黄斑中心凹模式进行治疗的黄色阈下激光（STL）治疗慢性中心性浆液性脉络膜视网膜病变的有效性和安全性，并通过扫频光学相干断层扫描分析激光治疗后脉络膜结构的变化。本研究是一项前瞻性病例系列研究，纳入了37例患者的43只眼。在STL治疗后6周、12周和24周记录数据。93%的患者最佳矫正视力提高，7%的患者保持稳定。分别有27.9%、32.6%和69.8%的患者在6周、12周和24周时视网膜下液完全吸收。在12周和24周时脉络膜厚度分别减少了13.1%和25.3%，分别对应脉络膜毛细血管层和萨特勒层在12周和24周时减少了17.5%和45.9%，哈勒层在12周和24周时减少了12.2%和21.2%（P<0.05）。这可能解释了激光对脉络膜内层血管系统的作用，其失调被认为是中心性浆液性脉络膜视网膜病变的核心。未检测到与激光相关的并发症。总体而言，在这一系列患者中，保留黄斑中心凹的STL是安全有效的。
