探析532 nm激光治疗CSCR的疗效  

Exploration on Curative Effect of 532 nm Laser on CSCR

作　　者：陈海燕[1] 左金霞[1] 甄宏博[1] 沈冰[1] 韩倩倩[1] 张旺 钟文 CHEN Haiyan;ZUO Jinxia;ZHEN Hongbo;SHEN Bing;HAN Qianqian;ZHANG Wang;ZHONG Wen(Department of Ophthalmology,the Sixth Hospital of Beijing,Beijing 100007,China)

机构地区：[1]北京市第六医院眼科,北京市100007

出　　处：《中国激光医学杂志》2022年第1期13-18,共6页Chinese Journal of Laser Medicine & Surgery

摘　　要：目的观察532 nm激光疗法与常规药物治疗中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSCR)的临床疗效差异。方法选择2018年4月至2021年1月,CSCR患者82例82只眼,利用随机数字表法分为药物组与激光组,每组患者各41例。其中,药物组口服卵磷脂络合碘片治疗,3 mg/次,2次/d,共8周;激光组采用激光治疗,波长532 nm,功率150~200 mW,曝光时间0.1 s,光斑直径150~200μm。治疗前,首次口服药物和第一次激光治疗后4、8、12和24周测量患者最佳矫正视力(best corrected visual acuity,BCVA)、黄斑中心凹视网膜厚度(central macular thickness,CMT)、平均光敏感度、角膜上皮细胞密度(endothelial cell density,CD)、平均细胞面积(average cell area,AVE),比较治疗前后两组患者神经上皮层和色素上皮层脱离高度,评估疗效。结果(1)治疗前激光组与药物组BCVA、CMT、平均光敏感度比较,差异均无统计学意义(P>0.05)。治疗后4、8、12和24周两组患者BCVA、平均光敏感度较治疗前均有显著提高;CMT较治疗前均有下降,且激光组治疗后4、8、12和24周BCVA、平均光敏感度高于药物组,CMT低于药物组(P<0.05)。(2)治疗前组间神经上皮层脱离高度、色素上皮层脱离高度比较,差异无统计学意义(P>0.05);治疗后两组均下降,激光组两项指标明显低于药物组(P<0.05);激光组治疗有效率明显高于药物组(P<0.05)。(3)治疗前两组角膜内皮细胞CD、AVE比较,差异无统计学意义(P>0.05);治疗后两组角膜内皮细胞CD、AVE与治疗前比较差异无统计学意义(P>0.05),两组间角膜内皮细胞CD、AVE比较差异无统计学意义(P>0.05)。结论临床治疗CSCR中给予患者532 nm激光治疗较药物治疗效果更显著,对患者视力、视网膜厚度、光敏感度改善效果更佳,可恢复其神经及色素上皮层功能,且对患者角膜内皮细胞影响小、安全可靠。Objective To observe the difference between 532 nm laser therapy and conventional drug therapy in treating central serous chorioretinopathy(CSCR).Methods A total of 82 CSCR patients(82 eyes)admitted during the period from Apr.2018 to Jan.2021 were collected and divided randomly into two groups:the drug group and laser group,41 cases in each group.The patients in the drug group were treated with lecithin-complexed iodine tablets,and those in the laser group with 532 nm laser.Their best corrected visual acuity(BCVA),macular foveal retinal thickness(CMT),average light sensitivity,corneal epithelial cell density(CD)and average cell area(AVE)before and 4,8,12 and 24 weeks after the treatment were measured.In addition,the detachment height of the epithelial layer and pigmented epithelium layer of the patients in two groups before and after the operation were compared to evaluate the curative effect.Results There was no significant difference in BCVA,CMT or average light sensitivity between the laser group and drug group before the treatment(P>0.05).For both groups,the BCVA and average light sensitivity were higher 4,8,12 and 24 weeks after the treatment than those before the treatment.Nevertheless,the CMT of both groups decreased 4,8,12 and 24 weeks after the treatment.The BCVA and average light sensitivity of the laser group were higher than those of the drug group,but the CMT lower than that of the drug group(P<0.05)4,8,12 and 24 weeks after the treatment.There was no significant difference in the height of neuroepithelial detachment and pigment epithelial detachment between two groups before the treatment(P>0.05).Despite of a decrease found in both groups after the treatment,both indexes in the laser group were significantly lower than those of the drug group(P<0.05).The effective rate of the laser group was significantly higher than that of the drug group(P<0.05).There was no significant difference in the CD and AVE of corneal endothelial cells between the two groups before the treatment(P>0.05).After the treatment

关 键 词：激光 中心性浆液性脉络膜视网膜 角膜内皮细胞 疗效 

分 类 号：R616.4[医药卫生—外科学] R773.4[医药卫生—临床医学]