复方樟柳碱注射液联合577 nm阈值下微脉冲激光治疗慢性中心性浆液性脉络膜视网膜病变的疗效  

Joint Efficacy of Compound Anisodine Hydrobromide Injection and 577 nm Micropulse Laser on Chronic Central Serous Chorioretinopathy

作　　者：陈王灵[1] 劳伟[1] 张秀妮[1] 梁晓茜 CHEN Wangling;LAO Wei;ZHANG Xiuni;LIANG Xiaoxi(Department of Ophthalmology,Hainan Eye Hospital,Zhongshan Eye Center,Sun Yat-sen University,Haikou 570311,China)

机构地区：[1]中山大学中山眼科中心海南眼科医院眼科,海口市570311

出　　处：《中国激光医学杂志》2023年第3期127-133,共7页Chinese Journal of Laser Medicine & Surgery

基　　金：2018年海南省卫生计生行业科研项目(1801320272A2001)。

摘　　要：目的探讨复方樟柳碱注射液联合波长577 nm阈值下微脉冲激光治疗慢性中心性浆液性脉络膜视网膜病变(chronic central serous chorioretinopathy,CSC)的疗效。方法选取2018年2月至2021年2月,慢性CSC患者90例。根据随机数字表法分为对照组和观察组,每组患者各45例。对照组采用577 nm阈值下微脉冲激光治疗;观察组采用复方樟柳碱注射液联合波长577 nm阈值下微脉冲激光治疗,两组激光治疗功率均为175~300 mW。治疗后1个月、3个月、6个月,比较两组患者的视物变形及中心暗点改善情况,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)、黄斑容积(total macular volume,TMV)、视网膜下液(subretinal fluid,SRF)面积和脉络膜毛细血管层(choroidal capillary layer,CCL)血流密度的变化。同时,观察不良反应发生情况。结果治疗后1个月、3个月、6个月,观察组中心暗点及视物变形改善情况均优于对照组(P<0.05)。两组治疗后3个月和6个月的BCVA均低于治疗前(P<0.05),观察组治疗后1个月、3个月和6个月的BCVA较同期对照组低(P<0.05)。两组治疗后1个月、3个月和6个月的CMT和TMV均低于本组治疗前(P<0.05)。治疗前和治疗后1个月、3个月和6个月,两组间的CMT和TMV相比,差异均无统计学意义(P>0.05)。两组治疗后1个月、3个月和6个月的SRF面积均低于本组治疗前(P<0.05)。观察组治疗后6个月的SRF面积低于同期对照组(P<0.05)。观察组治疗后1个月、3个月和6个月的CLL血流密度均高于本组治疗前(P<0.05),对照组治疗后的CLL血流密度则与治疗前无明显差异(P>0.05)。治疗后1个月、3个月和6个月,观察组的CLL血流密度高于对照组(P<0.05)。结论复方樟柳碱注射液联合577 nm阈值下微脉冲激光治疗CSC,可有效改善中心暗点及视物变形情况和BCVA,视网膜下液明显消退,但CMT改善并不明显。Objective To investigate the joint efficacy of compound anisodine hydrobromide injection and 577 nm micropulse laser in treating chronic central serous chorioretinopathy(CSC).Methods Totally 90 patients with chronic CSC treated between Feb.2018 and Feb.2021 were selected and divided randomly into two groups:the control group(n=45)and observation group(n=45).The patients in the control group were treated solely with 577 nm micropulse laser,and those in the observation group were given compound anisodine hydrobromide injection in addition.For both groups,the improvement of visual distortion and central scotoma 1,3 and 6 months after the treatment were observed and the best corrected visual acuity(BCVA),central macular thickness(CMT),total macular volume(TMV),subretinal fluid(SRF)area and choroidal capllary layer(CCL)blood flow density were recorded before the treatment and 1,3 and 6 months after the treatment respectively.Meanwhile,the occurrence of adverse reactions was observed.Result The improvement of central scotoma and visual deformation in the observation group were better than those in the control group(P<0.05)1,3 and 6 months after the treatment.The BCVA of 3 or 6 months afer the treatment was lower than that before the treatment(P<0.05)in both groups,and the BCVA in the observation group was lower than that in the control group 1,3 and 6 months after the treatment(P<0.05).The CMT and TMV of 1,3 and 6 months after the treatment were lower than those before treatment in both groups(P<0.05),but the diference between two groups was not significant(P>0.05).The SRF area of 1,3 and 6 months after the treatment was smaller than that before the treatment in both groups(P<0.05),and the SRF area of the observation group was smaller than that in the control group 6 months after treatment(P<0.05).The blood flow density of CLL in the observation group 1,3 and 6 months after the treatment was greater than that before treatment(P<0.05),but the difference was not significant in the control group(P>0.05).Moreover,the CLL b

关 键 词：激光 复方樟柳碱注射液 中心性浆液性脉络膜视网膜病变 慢性 疗效 

分 类 号：R779.63[医药卫生—眼科] R773.4[医药卫生—临床医学]