微脉冲激光阈值下治疗黄斑软性玻璃膜疣和玻璃膜疣性DPED的形态学改变

Morphological changes of macular soft drusen and drusenoid DPED after subthreshold micropulse laser treatment

目的:分析阈值下微脉冲激光(SMLT)治疗黄斑软性玻璃膜疣与玻璃膜疣性色素上皮脱离(DPED)的形态学改变。方法:回顾性横断面病例系列研究。2016-08/2018-10临床确诊的黄斑软性玻璃膜疣与DPED 14例20眼纳入研究,用577 nm黄激光对黄斑软性玻璃膜疣与DPED进行SMLT治疗。观察黄斑软性玻璃膜疣与DPED治疗后BCVA,FAF与SD-OCT测量的纵径,横径,病灶面积的改变。结果:黄斑软性玻璃膜疣治疗后BCVA与基线比较,差异无统计学意义(P=0.260),DPED治疗后BCVA与基线比较无统计学差异(P=0.736)。黄斑软性玻璃膜疣与DPED横径,纵径,截面积治疗后6mo与基线比较,黄斑软性玻璃膜疣纵径高度降低,截面积缩小,与基线比较有显著性差异(P=0.008;0.034)。DPED治疗前后横径,纵径高度与截面积与基线比较无统计学差异。结论:SMLT治疗黄斑软性玻璃膜疣与DPED后BCVA没有下降。黄斑软性玻璃膜疣纵径高度与截面积均较治疗前下降。DPED与基线比较无明显改变。结果表明SMLT治疗黄斑软性玻璃膜疣是有效的,但短期DPED疗效不明显,对黄斑软性玻璃膜疣与DPED视力无损害,但仍需要前瞻性、对照、大样本及长期随访观察。

·AIM:To analyze the morphological changes of macular soft drusen and drusenoid pigmental epithulium detachment(DPED)after subthreshold micropulse laser treatment(SMLT).·METHODS:Fourteen patients(20 affected eyes)with soft drusen and DPED clinically confirmed from August 2016 to October 2018,were included in this study.577 nm yellow laser of SMLT was applied for soft drusen and DPED.The changes of soft drusen and DPED in best corrected visual acuity(BCVA)(LogMAR)and height,diameter and cross-sessional area according to fundus autofluorescence and SD-OCT examinations were observed after SMLT.·RESULTS:BCVA was not significant difference after treatment of soft drusen(P=0.260),and the DPED(P=0.736)than that of the baseline.Compared with the baseline values,the height and cross-sessional area of soft drusen were reduced at the 6mo after treatment(P=0.008,P=0.034).Compared with the baseline values,the differences were not statistically significant in height,diameter and cross-sectional area of DPED after treatment.·CONCLUSION:BCVA was not reduced for drusen and DPED after SMLT,however,the height and cross-sessional area of soft drusen was reduced compared with those before treatment,and the differences were not statistically significant in height,diameter and cross-sectional area of DPED before and after treatment.The results indicated that SMLT was effective for soft drusen,but was not effective for short-term treatment of DPED.SMLT caused no damage to the visual acuity in treatment of soft drusen and DPED,but prospective,controlled,large sample and long-term follow-up studies should be required.