微脉冲半导体激光治疗CSC的初步观察

Primary study of micropulse diode laser photocoagulation for central serous chorioretinopathy

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。

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.