阈值下微脉冲激光治疗多模式成像分类的中心性浆液性脉络膜视网膜病变的疗效观察  

Observation on the efficacy of subthreshold micropulse laser photocoagulation in the treatment of central serous chorioretinopathy based on multimodal imaging classification

作　　者：肖蓓 宋艳萍 闫明 叶娅 黄珍 陈丛 邓玉梦 XIAO Bei;SONG Yanping;YAN Ming;YE Ya;HUANG Zhen;CHEN Cong;DENG Yumeng(The First School of Clinical Medicine,Southern Medical University,Guangzhou 510515,Guangdong Province,China;Department of Ophthalmology,General Hospital of Central Theater Command,Wuhan 430070,Hubei Province,China)

机构地区：[1]南方医科大学第一临床医学院,广东省广州市510515 [2]中国人民解放军中部战区总医院眼科,湖北省武汉市430070

出　　处：《眼科新进展》2024年第7期531-535,共5页Recent Advances in Ophthalmology

基　　金：国家重点研发计划“常见多发病防治研究”重点专项(编号:2022YFC2502800)。

摘　　要：目的观察577 nm阈值下微脉冲激光光凝(SMLP)对中心性浆液性脉络膜视网膜病变(CSC)的疗效,探究新的多模式成像分类CSC的基线特征和预后特点。方法回顾性分析2017年6月至2022年5月于中国人民解放军中部战区总医院眼科确诊的CSC患眼44例(46眼),依据新的多模式成像分类分为单纯性CSC组(23眼)和复杂性CSC组(23眼),所有患眼均使用577 nm SMLP治疗。比较两组患眼基线及治疗后1、3、6个月最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)的变化,同时观察基线及随访6个月后两组CSC患眼组内、组间变化及视网膜下液(SRF)的完全吸收率。结果单纯性CSC组患眼的BCVA治疗后6个月较基线时明显提高(P=0.010);复杂性CSC组患眼的BCVA治疗后3、6个月均较基线时明显提高(均为P<0.01)。单纯性CSC组患眼的CMT治疗后1、3、6个月均较基线时显著降低(均为P<0.05);复杂性CSC组患眼的CMT治疗后1、6个月均较基线显著降低(均为P<0.05);单纯性CSC组患眼治疗后6个月较基线时CMT的改变量为(-163.74±88.10)μm,复杂性CSC组患眼为(-71.96±164.30)μm,两组相比差异有统计学意义(P=0.023)。随访期间,单纯性CSC组患眼持续性SRF眼数明显低于复杂性CSC组(P<0.05)。单纯性CSC组患眼治疗后6个月的SRF完全吸收率大于复杂性CSC组(P<0.05)。结论577 nm SMLP治疗单纯性CSC的预后优于复杂性CSC,新的基于多模式成像分类CSC对预测SMLP治疗的预后具有一定价值。Objective To observe the efficacy of 577 nm subthreshold micropulse laser photocoagulation(SMLP)on central serous chorioretinopathy(CSC)and explore the baseline characteristics and prognostic features of multimodal imaging-based CSC.Methods A retrospective analysis was conducted on 44 patients(46 eyes)with CSC diagnosed at the Ophthalmology Department of the General Hospital of Central Theater Command,PLA from June 2017 to May 2022.The patients were classified into the simple CSC group(23 eyes)and the complex CSC group(23 eyes)based on the multimodal imaging classification.All patients underwent 577 nm SMLP treatment.The best corrected visual acuity(BCVA)and central macular thickness(CMT)of patients between the two groups were compared before treatment and at 1,3 and 6 months after treatment.The intra-group and inter-group changes and the complete absorption rate of subretinal fluid(SRF)in CSC eyes of patients between the two groups were assessed before treatment and at 6 months after follow-up.Results The BCVA of patients in the simple CSC group significantly improved at 6 months after treatment compared with the baseline(P=0.010);the BCVA of patients in the complex CSC group significantly improved at 3 and 6 months after treatment compared with the baseline(both P<0.01).The CMT of patients in the simple CSC group was significantly lower than the baseline at 1,3,and 6 months after treatment(all P<0.05);the CMT of patients in the complex CSC group was significantly lower than the baseline at 1 and 6 months after treatment(both P<0.05);the change in CMT from baseline after 6 months of treatment for simple CSC was(-163.74±88.10)μm,the change in CMT from baseline after 6 months of treatment for complex CSC was(-71.96±164.30)μm,and the difference between the two groups was statistically significant(P=0.023).During the follow-up period,the number of eyes with persistent SRF in the simple CSC group was significantly lower than that in the complex CSC group(P<0.05).The complete absorption rate of SRF at 6 months aft

关 键 词：中心性浆液性脉络膜视网膜病变 微脉冲激光光凝 视网膜下液 多模式成像 

分 类 号：R773.4[医药卫生—眼科]