阈值下TTT激光治疗CCSC所致的浆液性视网膜脱离

Therapy of the serous neurosensory detachment caused by CCSC by using subthreshold TTT

目的:报告阈值下经瞳孔温热疗法(transpupillary thermotherapy,TTT)在治疗慢性中心性浆液性脉络膜视网膜病变(chronic central serous chorioretinopathy,CCSC)继发的视网膜神经上皮浆液性脱离的效果。方法:选取视网膜神经上皮浆液性脱离持续时间达≥6mo的CCSC患者10例13眼。采用810nm半导体激光给予阈值下TTT激光治疗。通过眼科检查、血管造影及光学相干断层扫描(optic coherence tomography,OCT)比较治疗前后病损变化情况,采用自身对照法进行最佳矫正视力(best-corrected visual acuity,BVCA)的对比研究。结果:TTT治疗平均(1.23±0.44)次。所有患者随访6mo。治疗前视力0.05～0.4(平均0.16±0.10),治疗后视力0.05～0.8(平均0.35±0.21),视力改善结果差异有统计学意义(P<0.05)。治疗后眼底荧光素血管造影(fundus fluorescein angiography,FFA)均未显示荧光染料渗漏,吲哚青绿血管造影(indocyanine green angiography,ICGA)未见明显脉络膜通透性增加,治疗区域没有出现与治疗相关的副作用。结论:阈值下TTT对存在持续神经上皮层脱离的CCSC具有明显治疗效果,同时未出现显著并发症。

· AIM ： To report the effects of subthreshold transpupillary thermotherapy （ TTT ） on the subsequent serous neurosensory detachment of chronic central serous chorioretinopathy （ CCSC）. · METHODS： Thirteen eyes of 10 CCSC patients who have been suffered serous neurosensory detachment for at least six months were treated with subthreshold TTT by using 810nm diode laser. Lesion changes have been compared via ophthalmic examination, angiography and OCT. The comparative study of the best corrected visual acuity （BCVA） was conducted under self-control method. · RESULTS： The average treatment of each patient by TTT was （1.23±0.44）. All patients were followed up for 6 months. Before treatment, visual acuity was 0. 05-0.4 （0. 16±0.10）, and after treatment the vision was 0.05-0.8 （0. 35 ± 0. 21 ）. The difference of visual acuity was statistically significant （ P 〈 0. 05 ）. No leakage of fluorescent dyes of FFA after treatment. No obvious choroidal permeability increase was noticed. The treatment-related side effects were not found in the treatment area. · CONCLUSION： The subthreshold TTT has obvious therapeutic effect on sustained neural epithelium detachment CCSC while there is no significant complications.