微脉冲激光治疗中心性浆液性脉络膜视网膜病变的临床疗效  

Therapeutic effect of micropuise photocoagulation on central serous chorioretinopathy

作　　者：毕燕龙[1] 荣翱[1] 李锦文[1] 

机构地区：[1]同济大学附属同济医院眼科,上海200065

出　　处：《中华眼底病杂志》2007年第1期45-47,共3页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察倍频Nd：YAG微脉冲激光治疗中心性浆液性脉络膜视网膜病变（CSC）的临床疗效。方法CSC55例58只眼，完全随机分成微脉冲激光治疗组（微脉冲组，25例26只眼）和传统激光治疗组（传统组，30例32只眼）。微脉冲组用倍频Nd：YAG激光对渗漏点及其外围视网膜照射；传统组用IRIS Oculight GL 532nm连续波长激光对渗漏点直接光凝。两组患者治疗前后行视力、检眼镜、荧光素眼底血管造影及激光光斑视网膜微视野检查，治疗后随访时间为10周。治疗后1h和1、5、10周还进行了眼底自发荧光检查。结果两组患者随访期内均无视力下降。治疗后2周最佳矫正视力，传统组由治疗前的0．50±0．17提高至0．79±0．22；微脉冲组由治疗前的0．47±0．18提高至0．83±0．21。两组比较，差异无统计学意义（X^2=0．70，P〉0．05）。治疗后5周视网膜微视野值，传统组激光治疗组光凝区由治疗前的（17．84±2．76）dB下降到（15．05±3．36）dB；微脉冲组光凝点处由治疗前的（17．13±2．38）dB上升到（20．78±2．72）dB。两组比较，差异有统计学意义（t=5．99，P〈0．001）。结论微脉冲激光可避免传统激光治疗时光感受器细胞损伤形成的视野暗点，是治疗CSC的有效和微损伤方法。Objective To evaluate the effect of double-frequency Nd： YAG micropulse photocoagulation on central serous chorioretinopathy （CSC）. Methods The clinical data of a total of 55 patients （58 eyes） with CSC undergoing laser photocoagulation therapy were retrospectively analyzed. The cases were divided into 2 groups：l, the micropulse group, the leakage points and the retina around were photociagulated with double-frequency Nd ：YAG laser in 25 patients （26 eyes）; 2. the conventional laser group, the leakage points were photocoagulated directly with continuous-wave length （Iris Oculight GL 532 nm） in 30 patients （32 eyes）. The examination of visual acuity, ocular fundus features, fundus flurescein angiography, and retinal microperimetry were performed before and after the treatment in both of the 2 groups. The follow-up period was 10 weeks. Autoflurescence measurement was performed 1 hour, 1, 5, and 10 weeks after the treatment. Results No decrease of the visual acuity was found in the two groups during the follow-up period. Two weeks after the treatment, the best corrected visual acuity increased from 0. 50±0. 17 to 0. 79± 0. 22 in conventional laser group and from 0. 47± 0. 18 to 0. 83± 0. 21 in micropulse laser group, and there was no statistical difference between the two groups after laser treatment （X^2= 0. 70,P〉0. 05）. Five weeks after the treatment, microperimetry value decreased from （17. 84± 2. 76）dB to （15. 05 ± 3. 36） dB in conventional laser group and increased from （17.13± 2.38） to （20. 78± 2.72） dB in micropulse laser group, and significant difference in the changes of values between the two groups （t = 5. 99, P〈0. 001） was found. Conclusions Micropulse photocoagulation can selectively target retinal pigment epithelial cells, and avoid scotoma of visual field because of injury of photoreceptor cells caused by conventional photocoagulation. It is an effective and less-invasive treatment for CSC.

关 键 词：脉络膜视网膜炎/治疗 激光凝固术/方法 治疗结果 

分 类 号：R686[医药卫生—骨科学]