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微脉冲激光治疗中心性浆液性脉络膜视网膜病变

Micropulse Laser Therapy in Central Serous Chorioretinopathy.

作者信息

Bodea Flaviu, Radu Andrei-Flavius, Bodog Ruxandra-Florina, Bodog Teodora Maria, Nicula Cristina Ariadna

机构信息

Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania.

Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.

出版信息

Clin Pract. 2024 Nov 14;14(6):2484-2490. doi: 10.3390/clinpract14060194.

DOI:10.3390/clinpract14060194
PMID:39585022
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11587133/
Abstract

: Central serous chorioretinopathy (CSCR) is a retinal condition characterized by the accumulation of subretinal fluid, often linked to elevated levels of endogenous corticosteroids and stress-related hormones, which can lead to visual disturbances. This connection may explain the association of CSCR with high stress levels and the use of corticosteroid medications. Although many cases resolve spontaneously, persistent or severe instances may require intervention. : Our report presents a case of acute CSCR in a 33-year-old male who developed the condition following corticosteroid treatment for acute parotiditis and left submandibular lymphadenopathy. Initial presentation was 6 weeks after corticosteroid treatment was initiated. Diagnostic evaluation with optical coherence tomography (OCT) and fluorescein angiography confirmed the presence of subretinal fluid at the retinal pigment epithelium-Bruch's membrane complex. Micropulse laser therapy (MPLT) was applied to address the leakage points, leading to significant fluid reduction at a two-week follow-up. By six weeks, the complete resolution of subretinal fluid was documented, with substantial visual recovery. : This case confirms MPLT as an effective treatment for CSCR, particularly when conservative management is insufficient. Unlike traditional photocoagulation, MPLT offers a safer alternative, minimizing the risk of retinal damage, such as permanent scotomas. : This case underscores the importance of carefully monitoring patients undergoing corticosteroid therapy for potential ocular complications and highlights the role of MPLT as a safe and effective option for managing persistent CSCR, protecting the surrounding retinal tissue from damage while achieving significant therapeutic outcomes.

摘要

中心性浆液性脉络膜视网膜病变(CSCR)是一种视网膜疾病,其特征是视网膜下液积聚,通常与内源性皮质类固醇和应激相关激素水平升高有关,这可能导致视觉障碍。这种关联或许可以解释CSCR与高压力水平以及皮质类固醇药物使用之间的联系。尽管许多病例可自发缓解,但持续性或严重病例可能需要干预。

我们的报告介绍了一名33岁男性急性CSCR的病例,该患者在接受急性腮腺炎和左下颌下淋巴结病的皮质类固醇治疗后患上此病。最初症状出现在开始皮质类固醇治疗6周后。通过光学相干断层扫描(OCT)和荧光素血管造影进行的诊断评估证实,在视网膜色素上皮-布鲁赫膜复合体处存在视网膜下液。采用微脉冲激光治疗(MPLT)来处理渗漏点,在两周的随访中导致液体显著减少。到六周时,记录到视网膜下液完全消退,视力有显著恢复。

该病例证实MPLT是治疗CSCR的有效方法,特别是在保守治疗不足时。与传统光凝不同,MPLT提供了一种更安全的选择,将视网膜损伤(如永久性暗点)的风险降至最低。

该病例强调了对接受皮质类固醇治疗的患者仔细监测潜在眼部并发症的重要性,并突出了MPLT作为治疗持续性CSCR的安全有效选择的作用,在实现显著治疗效果的同时保护周围视网膜组织免受损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11587133/93bd5e2486af/clinpract-14-00194-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11587133/797b32aaea8d/clinpract-14-00194-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11587133/f0a831cdd365/clinpract-14-00194-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11587133/93bd5e2486af/clinpract-14-00194-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11587133/797b32aaea8d/clinpract-14-00194-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11587133/f0a831cdd365/clinpract-14-00194-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/11587133/93bd5e2486af/clinpract-14-00194-g003.jpg

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