激光光凝治疗中心性浆液性脉络膜视网膜病变视网膜下液吸收后视网膜微结构的变化  

Changes of Retinal Microstructure after Laser Photocoagulation for Central Serous Chorioretinopathy

作　　者：王雨晴 张招德 吴晶晶[1] 黄翠婷 陈艳榕 蒋官森 WANG Yu-qing;ZHANG Zhao-de;WU Jing-jing;HUANG Cui-ting;CHEN Yan-rong;JIANG Guan-sen(Department of Ophthalmology,Ningde Hospital Affiliated to Ningde Normal University,Ningde 352100,China)

机构地区：[1]宁德师范学院附属宁德市医院眼科,宁德市352100

出　　处：《中国激光医学杂志》2021年第2期77-81,共5页Chinese Journal of Laser Medicine & Surgery

基　　金：福建医科大学启航基金(2019aH1306)。

摘　　要：目的探讨激光光凝治疗中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)时视网膜下液(subretinal fluid,SRF)完全吸收后视网膜微结构的变化及其与视力的关系。方法选取2018年1月至2019年4月,激光光凝治疗后SRF完全吸收的CSC患者68例68只眼,进行最佳矫正视力(best corrected visual acuity,BCVA)检查和频域光相干断层扫描(spectral domain optical coherence tomography,SD-OCT)检查。分析中心凹视网膜厚度(central foveal thickness,CFT)、中央凹外核层(outer nuclear layer,ONL)厚度、光感受器内节(inner section,IS)和外节(outer section,OS)厚度,中心凹下椭圆体带和嵌合体带的完整性和视网膜色素上皮(retinal pigment epithelium,RPE)平滑性。结果与首次随访比较,末次随访时BCVA明显升高(P<0.05),与CFT、ONL厚度、IS厚度、OS厚度、椭圆体带和嵌合体带完整占比、RPE平滑占比明显升高(P<0.05)。首次随访和末次随访时,椭圆体带和嵌合体带完整、RPE平滑患者的BCVA较高(P<0.05)。末次随访时椭圆体带和嵌合体带完整性及RPE平滑性未恢复的患者BCVA未见明显升高(P>0.05)。随访前后视网膜微结构定量指标的减分值均与BCVA减分值呈正相关(P<0.05)。结论对激光光凝治疗的CSC患者,SRF完全吸收后CFT、ONL厚度、IS厚度、OS厚度、椭圆体带和嵌合体带完整占比、RPE平滑占比明显升高,并且上述指标与视力改善有关。Objective To investigate the changes of retinal microstructure after the overall subretinal fluid(SRF)absorption caused by the treatment of central serous chorioretinopathy(CSC)with laser photocoagulation and its relationship with visual acuity.Methods Totally 68 cases(68 eyes)of CSC patients from Jan.2018 to Apr.2019 and achieved complete absorption of SRF after laser photocoagulation were selected for best corrected visual acuity(BCVA)and frequency domain optical coherence tomography(SD-OCT)examinations.Their thicknesses of fovea retina(CFT),outer nuclear layer(onl),photoreceptor inner segment and outer segment(OS),integrity of foveal ellipsoid band and chimeric band and smoothness of retinal pigment epithelium(RPE)were analyzed.Results As to the last follow-up,the BCVA,CFT,onl thickness,IS thickness,OS thickness,proportion of intact ellipsoid zone and chimeric zone,and RPE smooth ratio increased significantly since the first follow-up(P<0.05).The results of both the first and last follow-up showed that BCVA was higher in patients with intact ellipsoid band and chimeric band and smooth RPE(P<0.05).The last follow-up also indicated that BCVA did not significantly increased in the patients whose integrity of ellipsoid band and chimeric band and RPE smoothness had not recovered(P>0.05).There was a positive correlation between the reduction of retinal microstructure quantitative index and BCVA score before and after the follow-up(P<0.05)Conclusions For CSC patients treated with laser photocoagulation,after full absorption of SRF,their CFT,ONL thickness,IS thickness,OS thickness,complete ratio of ellipsoid and chimera bands and RPE smooth ratio will increase significantly,and these indicators are related to visual acuity improvement.

关 键 词：激光 中心性浆液性脉络膜视网膜病变 频域光相干断层扫描 视力 

分 类 号：R616.4[医药卫生—外科学] R774[医药卫生—临床医学]