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经阈下微脉冲激光治疗的中心性浆液性脉络膜视网膜病变的预后因素。

Prognostic factors of visual outcome in central serous chorioretinopathy treated with subthreshold micropulse laser therapy.

机构信息

National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.

Ophthalmology Department, Taizhou Hospital, Zhejiang Province, Taizhou, China.

出版信息

Lasers Med Sci. 2024 Oct 10;39(1):256. doi: 10.1007/s10103-024-04207-8.

Abstract

Analyze the prognostic factors of visual outcome in central serous choriretinopathy (CSC) treated with subthreshold micropulse laser (SML) therapy through the most fundamental medical history and clinical examinations. It was a retrospective clinical study. We collected the most fundamental medical history and clinical examinations of CSC patients who received SML treatment, including visual acuity (VA) and spectral-domain optical coherence tomography (SD-OCT) of macular. Eyes were divided into two groups according the change of central macular thickness (CMT) before and one month after SML: CMT improvement and CMT deterioration group; divided into three groups according the change of VA: VA improvement, VA stability and VA decline group. Seventy-eight patients (eighty-three eyes) were enrolled. The baseline CMT was 339.83 ± 115.72 μm, and the baseline VA was 0.43 ± 0.36. One month after SML, CMT was 281.13 ± 121.48 μm, had a significant statistical improvement (p = 0.000); and VA was 0.46 + 0.42, had no significant statistical difference compared to baseline VA (p = 0.114). CMT of sixty-three eyes (75.90%) declined, and twenty eyes (24.10%) increased; VA of thirty-one eyes (37.35%) improved, fourteen eyes (16.87%) remained unchanged, and thirty-eight eyes (45.78%) declined. CMT and VA of twenty-seven eyes (32.53%) were both improved, and eleven eyes (13.25%) were both deteriorated. VA one month after SML was statistically correlated with age (p = 0.000), baseline VA (p = 0.000), and baseline CMT (P = 0.002). CMT and VA both improved one month after SML, and the improvement of CMT was more significant than VA. Elder age and poorer baseline vision indicated poorer VA one month after SML, while higher baseline CMT indicated better VA one month after SML.

摘要

通过最基本的病史和临床检查分析接受阈下微脉冲激光(SML)治疗的中心性浆液性脉络膜视网膜病变(CSC)的预后因素。这是一项回顾性临床研究。我们收集了接受 SML 治疗的 CSC 患者的最基本病史和临床检查,包括黄斑的视力(VA)和光谱域光相干断层扫描(SD-OCT)。根据 SML 治疗前后中央黄斑厚度(CMT)的变化,将眼分为两组:CMT 改善组和 CMT 恶化组;根据 VA 的变化,将眼分为三组:VA 改善组、VA 稳定组和 VA 下降组。共纳入 78 例(83 只眼)患者。基线 CMT 为 339.83±115.72μm,基线 VA 为 0.43±0.36。SML 治疗后 1 个月,CMT 为 281.13±121.48μm,有显著统计学意义(p=0.000);VA 为 0.46+0.42,与基线 VA 无显著统计学差异(p=0.114)。63 只眼(75.90%)的 CMT 下降,20 只眼(24.10%)升高;31 只眼(37.35%)的 VA 改善,14 只眼(16.87%)不变,38 只眼(45.78%)下降。27 只眼(32.53%)的 CMT 和 VA 均改善,11 只眼(13.25%)均恶化。SML 治疗后 1 个月的 VA 与年龄(p=0.000)、基线 VA(p=0.000)和基线 CMT(P=0.002)均有统计学相关性。SML 治疗后 1 个月 CMT 和 VA 均改善,且 CMT 改善程度大于 VA。年龄较大和基线视力较差提示 SML 治疗后 1 个月 VA 较差,而基线 CMT 较高提示 SML 治疗后 1 个月 VA 较好。

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