低能量810 nm激光治疗黄斑区中心性浆液性脉络膜视网膜病变的安全性及疗效

目的　探讨低能量810 nm激光治疗黄斑区中心性浆液性脉络膜视网膜病变（central serous chorioretinopathy，CSC）的安全性和疗效。方法　选取在我院确诊的黄斑区CSC单眼发病患者38例，随机分为2组:药物治疗组18例18眼，激光治疗组20例20眼。药物治疗组采用口服云南白药胶囊和维生素片；激光治疗组采用口服药物（云南白药胶囊和维生素片）和810 nm激光联合治疗。于治疗前及治疗后对患者行最佳矫正视力、视野、黄斑区OCT和眼底血管造影检查，统计分析各指标。结果　药物治疗组患眼治疗前最佳矫正视力为4.91±0.16，治疗后为4.92±0.16，治疗前后比较，差异无统计学意义（P>0.05）。激光治疗组患眼治疗前最佳矫正视力为4.93±0.12，治疗后为4.98±0.06，治疗前后比较，差异亦无统计学意义（P>0.05）。治疗前与治疗后药物治疗组与激光治疗组患眼最佳矫正视力组间比较，差异均无统计学意义（均为P>0.05）。治疗后3个月，激光治疗组患眼总体偏差视敏度为（-1.03±0.86）dB，与对侧眼总体偏差视敏度［（-0.85±0.72）dB］相比，差异无统计学意义（t=0.83，P=0.42）；与患眼治疗前总体偏差视敏度［（-3.75±3.28）dB］相比，差异有统计学意义（t=4.53，P<0.05）。治疗3个月后复查，药物治疗组8眼治愈，治愈率为44.5%；激光治疗组17眼治愈，治愈率为85.0%，激光治疗组治愈率明显高于药物治疗组，差异有统计学意义（P<0.05）。结论　低能量810 nm激光治疗黄斑区CSC是安全有效的。

Safety and efficacy of low-energy 810 nm laser in treatment of central serous chorioretinopathy in macular area

Objective To investigate the safety and clinical efficacy of low-energy 810 nm laser in the treatment of patients with central serous chorioretinopathy(CSC)in macular area.Methods Totally 38 patients(38 eyes)diagnosed with CSC in macular area were enrolled in the study,and randomly divided into 2 groups:18 patients(18 eyes)in the drug treatment group,and 20 patients(20 eyes)in the laser treatment group.Patients in drug treatment group received oral administration of Yunnan Baiyao Capsules and Vitamin Tablets,and those in laser treatment group received combined treatment of oral drugs(Yunnan Baiyao Capsules and Vitamin Tablets)and 810 nm laser.The best corrected visual acuity(BCVA),visual field and macular OCT were detected,and fundus angiography was performed before and after treatment.All data were statistically analyzed.Results For affected eyes in the drug treatment group,BCVA was 4.91±0.16 before treatment and 4.92±0.16 after treatment,and there was no statistical difference before and after treatment(P>0.05).For affected eyes in the laser treatment group,BCVA was 4.93±0.12 before treatment and 4.98±0.06 after treatment,and there was no statistical difference before and after treatment(P>0.05).Comparing with laser treatment group,no significant difference was found in BCVA of affected eyes for drug treatment group before or after treatment(all P>0.05).Three months after treatment,the total deviant visual acuity was(-1.03±0.86)dB for affected eyes and(-0.85±0.72)dB for contralateral eyes in laser treatment group,which had no statistical difference(t=0.83,P=0.42);the total visual acuity was(-3.75±3.28)dB for affected eyes before treatment,which had statistical difference with that of affected eyes 3 months after treatment(t=4.53,P<0.01).During re-examination 3 months after treatment,there were 8 eyes cured in drug treatment group and 17 eyes cured in laser treatment group,with cure rates of 44.5%and 85.0%,respectively.The laser treatment group had a statistically higher cure rate than that in drug treatment group(P<0.05).Conclusion Low-energy 810 nm laser is safe and effective for the treatment of CSC in the macular area.