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非破坏性视网膜激光疗法治疗视网膜色素变性相关性黄斑囊样水肿的短期疗效与安全性

Short-term efficacy and safety of nondamaging retinal laser therapy for retinitis pigmentosa-associated cystoid macular edema.

作者信息

Kaya Seda Çevik, Çitirik Mehmet, Yilmaz Mevlüt, Şensoy Eyüpcan

机构信息

Department of Ophthalmology, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkiye.

出版信息

Turk J Med Sci. 2025 Apr 17;55(3):652-657. doi: 10.55730/1300-0144.6012. eCollection 2025.

DOI:10.55730/1300-0144.6012
PMID:40686715
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12270286/
Abstract

BACKGROUND/AIM: To evaluate the short-term efficacy and safety of nondamaging retinal laser therapy (NRT) for retinitis pigmentosa-associated cystoid macular edema (RP-CME) and analyze anatomical and functional outcomes.

MATERIALS AND METHODS

A retrospective case series of 40 eyes from 30 patients with RP-CME was conducted. The patients underwent NRT using a PASCAL laser system with endpoint management (EpM) software. Central macular thickness (CMT) and best-corrected visual acuity (BCVA) were assessed at baseline and 2 months posttreatment. Long-term follow-up data, including recurrence rates were also reviewed.

RESULTS

At the 2-month follow-up, NRT significantly reduced mean CMT by 79.7 μm (p < 0.001) and improved BCVA by 0.10 LogMAR (p < 0.001). Complete resolution of CME was observed in 30% of the eyes, while 52.5% experienced recurrence within 6 months. Unilateral cases exhibited greater CMT reductions than bilateral cases (p < 0.05). No retinal damage from the laser was observed. The long-term sustainability of these effects remains unclear, and repeated treatments have not yet been assessed.

CONCLUSION

NRT is a safe and effective short-term treatment for RP-CME, achieving significant anatomical and functional improvements without evidence of retinal damage. However, the high recurrence rate and absence of long-term data warrant further investigation. Future studies should explore repeated treatments, genetic subtypes, and correlations with the ellipsoid zone integrity.

摘要

背景/目的:评估非破坏性视网膜激光治疗(NRT)对视网膜色素变性相关性黄斑囊样水肿(RP-CME)的短期疗效和安全性,并分析解剖学和功能结局。

材料与方法

对30例RP-CME患者的40只眼进行回顾性病例系列研究。患者使用带有终点管理(EpM)软件的PASCAL激光系统接受NRT治疗。在基线和治疗后2个月评估中心黄斑厚度(CMT)和最佳矫正视力(BCVA)。还回顾了长期随访数据,包括复发率。

结果

在2个月的随访中,NRT使平均CMT显著降低79.7μm(p<0.001),BCVA提高0.10 LogMAR(p<0.001)。30%的患眼中CME完全消退,而52.5%在6个月内复发。单侧病例的CMT降低幅度大于双侧病例(p<0.05)。未观察到激光对视网膜造成损伤。这些效果的长期可持续性尚不清楚,且尚未评估重复治疗情况。

结论

NRT是治疗RP-CME的一种安全有效的短期治疗方法,可实现显著的解剖学和功能改善,且无视网膜损伤证据。然而,高复发率和缺乏长期数据值得进一步研究。未来的研究应探索重复治疗、基因亚型以及与椭圆体带完整性的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5467/12270286/297aea4befc9/tjmed-55-03-652f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5467/12270286/1eb028056328/tjmed-55-03-652f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5467/12270286/59b8805d81f5/tjmed-55-03-652f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5467/12270286/297aea4befc9/tjmed-55-03-652f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5467/12270286/1eb028056328/tjmed-55-03-652f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5467/12270286/59b8805d81f5/tjmed-55-03-652f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5467/12270286/297aea4befc9/tjmed-55-03-652f3.jpg

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本文引用的文献

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PLoS One. 2024 Jan 2;19(1):e0296493. doi: 10.1371/journal.pone.0296493. eCollection 2024.
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Protocol for the treatment of cystoid macular edema secondary to retinitis pigmentosa and other inherited retinal dystrophies.治疗因色素性视网膜炎和其他遗传性视网膜营养不良引起的囊样黄斑水肿的方案。
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Non-damaging retinal laser therapy in chronic central serous chorioretinopathy.
非损伤性视网膜激光疗法治疗慢性中心性浆液性脉络膜视网膜病变。
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