中心性浆液性脉络膜视网膜病变的激光和非激光治疗  

The treatment of central serous chorioretinopathy with or without laser photocoagulation

作　　者：蔡季平 李玉珍 程金伟 魏锐利 

机构地区：[1]上海第二军医大学第二附属医院眼科,上海200003

出　　处：《中国实用眼科杂志》2008年第12期1325-1327,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的通过对比研究，评价氪黄激光治疗中心性浆液性脉络膜视网膜病变（central serous chorioretinopathy，CSC）的治疗和预防复发的效果。方法回顾性分析经眼底荧光血管造影（fundus fluorescein angiography，FFA）确诊为CSC的患者67例（68只眼）的临床治疗效果，比较单纯药物治疗与氪黄激光（波长568nm，光斑直径100μm，曝光时间0．1s，功率60～120mw）联合口服药治疗，在治愈率、治愈时间和复发率等方面的差异。随访时间为治疗后1个月、3个月、半年、1年、2年和3年。结果激光组（39例39只眼）的治愈率为92．3％（36／39），平均治愈时间（32．8±8．9）d，复发3例（3只眼），占7．7％；单纯药物组（28例29只眼）的治愈率为86．2％（25／29），平均治愈时间（69．4±17．2）d，复发8例（8只眼），占27．6％。两组比较，治愈率无明显差异（χ^2=0．670，P〉0．05），平均治愈时间天数有明显差异（t=2．667，P〈0．01），复发率有明显差异（χ^2=4．854，P〈0．05）。结论氪黄激光治疗CSC安全、有效，对缩短病程和降低复发率效果明显。Objective To evaluate the therapeutic effect of laser photocoagulation for central serous chorioretinopathy （CSC）and its preventive effect of recurrence.Methods This was a retrospective clinical study.Sixty-seven cases（ 68 eyes）of CSC, which were diagnosed by fundus fiuorescein angiography, were treated by oral drugs （29 eyes,group A）or krypton yellow laser along with oral crngs （39 eyes,group B）.The patients were followed up at 1,3,6, 12,24 and 36 months after treatment.Results Twenty-four patients （25 eyes ）recovered within an average time of 69.4±17.2 days with 8 eyes recurrence （27.6%）in group A, while 39 patients（39 eyes）recovered within an average time of 32.8±8.9 days with 3 eyes recurrence（7.7%）in group B. There was a significant difference between the two groups in the respect of recurrence （χ^2=4.854, P 〈0.05 ）.No complication was found.Conclusion Krypton yellow laser photocoagulation is a safe and effective method for the treatment of central serous chorioretinopathy, especially it could reduce the recurrent rate.

关 键 词：中心性浆液性脉络膜视网膜病变 激光凝固术 临床分析 治疗方法 

分 类 号：R774.1[医药卫生—眼科]