经瞳孔温热疗法治疗慢性中心性浆液性脉络膜视网膜病变

Transpupillary thermotherapy for chronic central serous chorioretinopathy

目的探讨经瞳孔温热疗法(TTT)治疗慢性中心性浆液性脉络膜视网膜病变(CSC)的临床疗效。方法采用半导体810红外激光对经荧光素眼底血管造影(FFA)和光相干断层扫描(OCT)确诊的CSC患者22例(24只眼)进行治疗,初诊时平均视力为0.4±0.25。治疗后随诊1、2、6个月时的视力,并行眼底检查、FFA及OCT检查。术后2个月渗漏和视网膜下液均消失者即为治疗成功,反之则认为失败。结果通过TTT治疗,OCT示视网膜神经上皮下积液完全吸收、FFA示脉络膜渗漏消失者随诊1个月时为17只眼(70.83%);随诊2个月时为21只眼(87.50%);随诊6个月时为23只眼(95.83%);1只眼在随诊6个月时积液持续未吸收。随诊6个月时14只眼(58.33%)视力提高3行或3行以上。结论TTT治疗CSC安全且有一定疗效,可能通过缩短病程而影响其视力预后。

Objective To explore the clinical effect of transpupillary thermotherapy（TTT）for the treatment of chronic central serous chorioretinopathy（CSC）.Methods Twenty-four eyes of twenty-two patients with long-standing CSC who opted for TTT and observation were enrolled in this study,TTT was performed using 810nm infrared diode laser. The primary average visual acuity is 0.4±0.25,all patients underwent international standard vision acuity measurement,fundus fundus examination,fundus fluorescein angiography（FFA） and optical coherence tomography（OCT）.Follow-up was scheduled at 1,2 and 6 months. Success was defined as resolution of neurosensory on OCT and disappearance of leakage on FFA at 3 months,and failure as persistence of the same.Results Following treatment of TTT,complete resolution of neurosensory detachment on OCT and disappearance of leakage on FFA was seen in seventeen eyes（70.83%）at month 1,twenty-one eyes （87.50%） at month 2 and twenty-three eyes（95.83%）at month 6,one eye had persistent subretinal fluid at month 6.Fourteen eyes（58.33%）had≥3 lines of improvement at final following visit.Conclusion Transpupillary thermotherapy could be a safely therapeutic option in patients with chronic CSC and subfoveal leaks,and it may affect the vision prognosis by shortening the persistent serous elevation of macula.