低能量TTT治疗中心凹下渗漏型CSC的临床研究  

Therapeutic efficacy of low power transpupillary thermotherapy on central serous chorioretinopathy with leakage under fovea centralis

作　　者：徐建锋[1] 叶瑞珍[1] 李贵洲[1] 蔡泽煌 

机构地区：[1]解放军第180医院眼科,福建省泉州市362000

出　　处：《眼科新进展》2014年第3期239-241,共3页Recent Advances in Ophthalmology

基　　金：南京军医"第十一五"医药卫生资助课题(编号:08MA083)~~

摘　　要：目的评价低能量经瞳孔温热疗法(transpupillary thermotherapy,TTT)治疗中心凹下渗漏型中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的效果。方法经眼底荧光血管造影(fundus fluorescein angiography,FFA)和光学相干断层扫描(optical coherence tomography,OCT)检查确诊为中心凹下渗漏型CSC患者40例(40眼),随机分为治疗组22例(22眼)和对照组18例(18眼)。治疗组采用810半导体激光进行低能量TTT治疗,对照组予口服复方血栓通胶囊和沃丽汀片。两组分别于治疗后2周、4周、8周、12周时行自觉症状(Amsler表)、最佳矫正视力(best corrected visual acuity,BCVA)、OCT检查,并于治疗后4周、12周时行FFA检查,对检查结果进行统计学分析。结果治疗后两组患者自觉症状减轻或消退,视力及视觉质量均有不同程度改善。两组在治疗后2周、4周、8周时视力提高和自觉症状改善方面进行比较,差异均有统计学意义(均为P<0.05)。FFA检查治疗后4周时对照组、治疗组荧光素渗漏点完全封闭者分别为50.0%、90.9%,两组间差异有统计学意义(P<0.05)。对照组治疗后2周、4周、8周黄斑中心凹厚度分别为(350±109)μm、(300±101)μm、(252±90)μm,治疗组黄斑中心凹厚度分别为(252±105)μm、(207±95)μm、(175±82)μm,荧光素渗漏点消失差异均有统计学意义(均为P<0.05),而在12周时差异无统计学意义(P>0.05)。治疗组在激光治疗过程及随访过程中均未发现与激光相关的的并发症以及复发,对照组有3例复发。结论低能量TTT治疗CSC安全、有效,能缩短病程,有助于保护黄斑功能,适用于中心凹下渗漏型CSC的治疗。Objective To investigate the clinic therapeutic efficacy of low power transpupillary thermotherapy（TTT） on central serous chorioretinopathy（CSC） with the leakage under fovea centralis. Methods Forty eyes of 40 patients that had been diag- nosed as CSC by fundus fluorescein angiography （FFA） and optical coherence tomo- graphy （OCT） were randomly divided into treated group （22 eyes） and control group （18 eyes）. Twenty-two patients in treated group had the 810 nm semiconductor laser treat- ment with low power, 18 patients in control group were given iodinized lecithin （Joletin） and Fufang Xueshuan Tong capsule treatment. All the patients were checked for Amsler chart,best corrected visual acuity, OCT at postoperative 2 weeks,4 weeks,8 weeks and 12 weeks,and FFA examination was performed at postoperative 4 weeks and 12 weeks. Results The rational symptoms were reduced or disappeared after treatment, the vis- ual acuity and visual quality were improved in two groups. There were statistical differ- ences in improvement of visual acuity and rational symptom at postoperative 2 weeks ,4 weeks and 8 weeks between two groups（ all P 〈 0.05 ）. The leakage spots closed rates at postoperative 4 weeks in treated group and control group were 50.0% and 90.9% , re- spectively, there was statistical difference （P 〈 0.05 ）. The macular fovea centralis thick- ness at postoperative 2 weeks,4 weeks,8 weeks and 12 weeks in control group were （350 ± 109） μm, （300 ± 101 ） μm, （252 ±90） μm and（ 172 ±65）μm, respectively, which in treated group were （252 ± 105 ）μm, （207 ± 95 ） μm, （ 175 ± 82 ） μm and （ 152 ± 69 ） μm, respectively, there were statistical differences at postoperative 2 weeks, 4 weeks and 8 weeks between two groups （ all P 〈 0. 05 ） ,but there was no statistical difference at postoperative 12 weeks（P 〉 0.05 ）. There is no serious complication and re- lapse in treated group during follow-up,but 3 cases in control group were recurre

关 键 词：中心性浆液性脉络膜视网膜病变 中心凹下 经瞳孔温热疗法 低能量 疗效 

分 类 号：R774.5[医药卫生—眼科]