微脉冲半导体激光治疗CSC的初步观察

目的:探讨微脉冲半导体激光治疗中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的疗效。方法:自身对照病例研究。将经荧光素眼底血管造影(fundus fluorescein angiography,FFA)和光学相干断层扫描(optic coherence tomography,OCT)检查确诊的典型性CSC患者12例12眼行微脉冲半导体激光治疗前及治疗后随访观察1,2wk;1,3mo的临床资料进行分析,主要以治疗前后的视力、自觉症状、眼底情况、FFA及OCT检查的改变为观察指标,以评价微脉冲半导体激光对CSC的治疗效果。结果:所有患者自觉症状减轻或消退,视力及视觉质量均有不同程度改善。激光光凝2wk和1mo后,分别有9眼(75.0%)和11眼(91.7%)的黄斑区水肿完全消退,3mo后全部患者黄斑区水肿消退。光凝2wk后,FFA检查发现有9眼荧光素渗漏完全消失,3眼渗漏减轻;OCT检查有9眼黄斑区视网膜下积液消失,中心凹视网膜厚度恢复正常,3眼黄斑区视网膜下积液大部分吸收。光凝1mo后,FFA检查有11眼荧光素渗漏完全消失;OCT检查有11眼黄斑区视网膜下积液消失,中心凹视网膜厚度恢复正常。光凝3mo后,FFA显示所有患眼的荧光素渗漏完全消失,未见明显"窗样缺损"样荧光;OCT检查发现所有患眼黄斑区视网膜下积液完全吸收。结论:微脉冲半导体激光治疗CSC是一种安全、有效的治疗方法,能有效缩短病程,提高患者视力,避免并发症的发生。

Primary study of micropulse diode laser photocoagulation for central serous chorioretinopathy

AIM: To investigate the effect of micropulse diode laser photocoagulation on central serous choroidretinopathy(CSC).

METHODS: Twelve patients diagnosed with CSC by fluorescein angiography(FFA)and optic coherence tomography(OCT)examination were treated with micropulse diode laser photocoagulation. The data of visual acuity testing, ophthalmic examination, color photographs, FFA and OCT before photocoagulation and 1 week, 2 weeks, 1 month, 3 months after it were used to evaluate the effects of micropulse diode laser photocoagulation.

RESULTS: All patients' self-conscious symptom and visual acuity improved differently. Nine and eleven eyes leakage point disappeared after micropulse diode laser photocoagulation in 2 weeks and one month in FFA. Nine and eleven eyes of subretinal effusion in OCT were absorbed after laser photocoagulation in 2 weeks and one month. All cases' leakage point and subretinal effusion disappeared after 3 months. The window defect in FFA did not occur in all laser treated eyes.

CONCLUSION: The micropulse diode laser photocoagulation could shorten the course of CSC, improve the patient's visual acuity and reduce the complications.