微脉冲激光与PDT治疗慢性中心性浆液性脉络膜视网膜病变的疗效比较  

Comparison of subthreshold micropulse laser treatm entand PDT in patients w ith chronic central serous chorioretinopathy

作　　者：石薇 张贵森 惠延年 刘磊[3] 张晓光 康艳杰 刘洋 Wei Shi;Gui-Sen Zhang;Yan-Nian Hui;Lei Liu;Xiao-Guang Zhang;Yan-Jie Kang;Yang Liu(Inner Mongolia Chaoju Eye Hospital, Hohhot 010050, Inner Mongolia autonomous region, China;Department of Ophthalmology, Air Force Medical University, Xijing Hospital, Xi'an 710015, China;The First Hospital of China Medical University, Shenyang 110001,China)

机构地区：[1]内蒙古朝聚眼科医院,内蒙古呼和浩特010050 [2]空军军医大学西京医院眼科,陕西西安710015 [3]中国医科大学附属第一医院眼科,辽宁沈阳110001

出　　处：《国际眼科杂志》2019年第6期1063-1067,共5页International Eye Science

摘　　要：目的:比较577nm阈值下微脉冲激光(SML)与光动力疗法(PDT)治疗慢性中心性浆液性脉络膜视网膜病变(cCSC)的效果和安全性。方法:收集2015-02/2018-04在我院就诊的cCSC患者30例30眼,577nm微脉冲激光治疗组和PDT治疗组各15例15眼。观察治疗后1、3、6mo两组患者BCVA、CMT和并发症发生情况。结果:治疗后1mo时SML组与PDT组BCVA分别提高到0.37±0.13、0.20±0.11(t=-3.93,P<0.001);CMT分别降低到382.80±76.54、247.60±28.46μm,两组均有显著改善,PDT组优于SML组(t=-6.41,P<0.001)。治疗后3、6mo,两组BCVA和CMT组间均无差异(P>0.05)。随访期间,眼底均未见明显并发症,无复发病例。结论:577nmSML与PDT治疗cCSC均有效,PDT治疗起效更快,但随着时间延长,两者疗效相近。577nmSML比PDT治疗费用低,且无创、无过敏等风险,可重复治疗。AIM: To compare the efficacy and safety of 577nm subthreshold micropulse laser (SML) and photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC). METHODS: Thirty patients (30 eyes) with cCSC were treated in our hospital from February 2015 to April 2018. And 15 patients (15 eyes) were treated with SML (577 nm) while the others were treated by PDT. The BCVA and CMT as well as complications were observed at 1, 3, 6mo after treatment. RESULTS: At 1mo after treatment, BCVA was increased to 0.37±0.13 in SML group and 0.20±0.11 in PDT group ( t =-3.93, P <0.001);CMT was decreased to 382.80±76.54μm in SML group and 247.60± 28.46μm in PDT group ( t =-6.41, P <0.001). Although improvements of BCVA and CMT were both achieved in two groups, improvements in PDT group were better than those in SML group. At 3mo and 6mo after treatment, both BCVA and CMT were no significant difference between the two groups ( P >0.05). During the follow-up period, there were no obvious complications or recurrence observed. CONCLUSION: Both SML (577nm) and PDT were effective and safe in the treatment of cCSC, but the theraputic effects of PDT was slightly quicker than SML. Further, with the prolongation of recovery time, the curative effects of these treatments were similar. Additionally, SML (577nm) costs was much cheaper than PDT and had no risk of injury or allergy for patients, and patients with cCSC could also be treated repeatedly using it.

关 键 词：慢性中心性浆液性脉络膜视网膜病变 577nm微脉冲激光 光动力疗法 黄斑中心凹视网膜厚度 相干光断层扫描 

分 类 号：R774.1[医药卫生—眼科]