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中心性浆液性脉络膜视网膜病变中脉络膜新生血管的直接导航聚焦激光光凝术。

Direct navigated focal laser photocoagulation of choroidal neovascularization in central serous chorioretinopathy.

作者信息

Maltsev Dmitrii S, Kulikov Alexey N, Vasiliev Alexandr S, Kazak Alina A, Kalinicheva Yana A, Chhablani Jay

机构信息

S.M. Kirov Military Medical Academy, Department and Clinic of Ophthalmology, 21 Botkinskaya Str., Saint-Petersburg, Russian Federation.

University of Pittsburgh, UPMC Eye Center, 203 Lothrop Street, Pittsburgh, US.

出版信息

Lasers Med Sci. 2025 Apr 3;40(1):173. doi: 10.1007/s10103-025-04425-8.

Abstract

AIM

To report the efficacy and safety of navigated focal laser photocoagulation (FLP) in the management of central serous chorioretinopathy (CSCR) complicated by choroidal neovascularization (CNV).

MATERIALS AND METHODS

This interventional case series included patients with CSCR complicated by CNV, defined as the presence of characteristic OCT angiography features. All patients underwent FLP targeting the area of CNV, using the navigated laser system followed by a minimum six-month follow-up. The main outcome measure was complete resolution of subretinal fluid at the end of follow-up.

RESULTS

This study included 16 eyes of 16 patients (6 males and 10 females, mean age 59.3 ± 7.9 years). Mean baseline CNV area was 0.44 ± 0.23 mm. All eyes achieved complete resolution of SRF at 1.1 ± 0.4 months after FLP. At the beginning and at the end of follow-up best-corrected visual acuity was 0.16 ± 0.17 and 0.07 ± 0.12 LogMAR (p = 0.12), respectively. Central retinal thickness decreased from 372.4 ± 83.06 to 215.3 ± 21.5 μm (p < 0.0001), while subfoveal choroidal thickness remained stable (344.6 ± 101.0 μm at baseline and 316.8 ± 99.9 μm at the end of the follow-up, p = 0.53). No visual or anatomical deterioration was observed during 11.5 ± 7.5 months of follow-up.

CONCLUSION

Navigated FLP of the area of CNV is an effective and safe option in the management of CSCR complicated by relatively small extrafoveal neovascular membranes.

摘要

目的

报告导航聚焦激光光凝术(FLP)治疗合并脉络膜新生血管(CNV)的中心性浆液性脉络膜视网膜病变(CSCR)的疗效和安全性。

材料与方法

本介入性病例系列研究纳入了合并CNV的CSCR患者,通过特征性光学相干断层扫描血管造影特征进行定义。所有患者均使用导航激光系统对CNV区域进行FLP治疗,随后进行至少6个月的随访。主要观察指标为随访结束时视网膜下液完全消退。

结果

本研究纳入16例患者的16只眼(男性6例,女性10例,平均年龄59.3±7.9岁)。平均基线CNV面积为0.44±0.23平方毫米。所有患眼在FLP治疗后1.1±0.4个月时视网膜下液均完全消退。随访开始时和结束时的最佳矫正视力分别为0.16±0.17和0.07±0.12 LogMAR(p = 0.12)。中央视网膜厚度从372.4±83.06微米降至215.3±21.5微米(p < 0.0001),而黄斑中心凹下脉络膜厚度保持稳定(基线时为344.6±101.0微米,随访结束时为316.8±99.9微米,p = 0.53)。在11.5±7.5个月的随访期间未观察到视力或解剖结构恶化。

结论

对CNV区域进行导航FLP是治疗合并相对较小黄斑外新生血管膜的CSCR的一种有效且安全的选择。

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