微脉冲联合迈之灵治疗CSC对脉络膜厚度的影响  

Effect of subthreshold micropulse laser combined with oral Maizhiling on choroid thickness of central serous chorioretinopathy

作　　者：孙玲娟 王海燕 殷莉 孟玲 王姝蕊 SUN Lingjuan;WANG Haiyan;YIN Li(Department of Ophthalmology,Shijiazhuang People’s Hospital,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市人民医院眼科,050011

出　　处：《河北医药》2024年第14期2122-2125,2130,共5页Hebei Medical Journal

摘　　要：目的研究微脉冲激光联合迈之灵治疗中心性浆液性脉络膜视网膜病变(CSC)前后脉络膜厚度变化。方法选取2018至2020年100例(100眼)于我院确诊的CSC患者及年龄、性别、眼轴相匹配的正常人100例(100眼),所有研究对象均采用频域相干断层扫描仪的脉络膜深层成保模式(EDI-OCT)检查,测量黄斑区脉络膜厚度,并进行对比分析。将确诊的100例中浆病患者随机分成研究组和对照组,每组50例(50眼):研究组患者给予577 nm微脉冲激光联合迈之灵治疗,对照组单纯给予迈之灵口服,并指导患者避免精神紧张、过度劳累及烟酒刺激等,所有研究对象均采用EDI-OCT检查,于初诊、治疗后1个月及6个月测量黄斑区脉络膜厚度,观察分析治疗前后脉络膜厚度变化。结果CSC组及正常人对照组中心凹下脉络膜厚度(SFCT)、中央区(CSM)、鼻内环(NIM)、上内环(SIM)、颞内环(TIM)、下内环(IIM)、鼻外环(NOM)、上外环(SOM)、颞外环(TOM)、下外环(IOM)脉络膜厚度差异有统计学意义(P<0.05)。CSC患眼组及对侧眼组SFCT、CSM、NLM、SIM、TIM、IIM、NOM、SOM、TOM、IOM比较,差异均有统计学意义(P<0.05)。研究组患者于治疗后1个月及6个月均较治疗前脉络膜厚度变薄,差异有统计学意义(P<0.05),而治疗后1个月及6个月对比差异无统计学意义(P>0.05)。结论CSC患者黄斑区脉络膜厚度较正常人增厚。577 nm微脉冲激光联合迈之灵治疗后CSC患者黄斑区脉络膜厚度变薄,且在治疗后1个月左右脉络膜厚度趋于稳定。微脉冲激光可激活视网膜色素上皮功能,恢复泵功能及外屏障,降低脉络膜通透性,脉络膜变薄达到治疗效果。Objective To observe the changes in pre-and post-treatment choroid thickness of central serous chorioretinopathy(CSC)by subthreshold micropulse laser(SML)combined with oral Maizhiling.Methods A total of 100 patients(100 eyes)with CSC diagnosed in our hospital from 2018 to 2020 and 100 healthy subjects(100 eyes)matching age,sex and eye axis.All subjects were examined by enhanced depth imaging optical coherence tomography(EDI-OCT),and the chorioretinal thickness in macular area was measured,and a comparative analysis was conducted.One-hundred confirmed CSC patients were randomly assigneded in a 1:1 ratio to oral administration of Maizhiling(control group)or 577-nm SML combined with oral Maizhiling(study group),and they were instructed to avoid mental stress,overwork,tobacco and alcohol stimulation,etc.All subjects were re-examined by EDI OCT,and the choroid thickness in macular area was measured on months 1 and 6 of treatment.The change in pre-and post-treatment choroid thickness was assessed.Results The differences were statistically significant in choroidal thicknesses of subfoveal choroidal thickness(SFCT),central subfield(CSF),nasal inner macula(NIM),superior inner macula(SIM),temporal inner macula(TIM),inferior inner macula(IIM),nasal outer macula(NOM),superior outer macula(SOM),temporal outer macula(TOM)and inferior outer macula(IOM)between CSC patients and normal controls(P<0.05).The differences were significant in the above indexes between the affected eye subgroup and contralateral eye subgroup in CSC patients(P<0.05).The choroid thickness of patients in the study group was significantly thinner on months 1 and 6 of treatment than those before treatment(P<0.05),but there was no statistically significant difference between 1 month and 6 months after treatment(P>0.05).Conclusion The macular choroidal thickness of CSC patients was thicker than that of normal subjects.After treatment with 577nm SML combined with oral Maizhiling,the macular choroidal thickness of CSC patients became thinner,and the choroid thic

关 键 词：中心性浆液性脉络膜视网膜病变 577 nm微脉冲激光 迈之灵 光学相干断层扫描 黄斑区脉络膜厚度 

分 类 号：R773.4[医药卫生—眼科]