中心性浆液性脉络膜视网膜病变激光治疗对中心视野的影响

Clinical study of the changes in central visual field of central serous chorioretinopathy induced by laser photocoagulation

目的 :分析中心性浆液性脉络膜视网膜病变 (central serous chorioretinopathy,CSC)自愈与激光治疗后中心视野 (central visualfield,CVF)的变化对比观察。方法 :连续就诊的 34例 38眼经眼底荧光血管造影 (fundus fluorescien angiography,FFA)确认的 CSC病人 ,单眼 30例 ,双眼 4例 ,其中 2 6眼呈“炊烟状”或“墨渍样”改变 ,作为激光治疗组 ;12眼呈“玻璃疣状”改变 ,不予激光治疗 ,作为自愈组给予维生素口服。治疗前及痊愈后均行 CVF检查。结果 :激光组 2 6眼治疗后平均 33.88± 11.71天视力恢复。其中发作次数少的 2 2眼 CVF完全恢复正常占 84.6 2 %。另 4眼复发次数较多 ,CVF异常 ,占 15 .38%。自愈组 12眼 ,平均 12 6 .6 7± 38.2 2天视力恢复 ,首次发作的 6眼 CVF恢复正常占 5 0 %。两组病程及视敏度相比 ,P<0 .0 5 ,有统计学意义。两组按复发次数多少分开比较 ,虽然激光组平均缺损 (mean defect,MD)、缺失偏离 (lossvariance,L V)比自愈组要好 ,但无统计学意义。结论 :CSC愈后 CVF异常与其反复发作呈正相关 ,而恰当的激光治疗不会造成

Analyze the changes in central visual field (CVF) of central serous chorioretinopathy (CSC) after laser photocoagulation treatment. Methods: Among 38 eyes of CSC diagnosed with FFA, 26 eyes were classified as subject group due to the 'spurt' or 'ink blot' found, 12 eyes were as self-cured control group for drusen found. For control group, only vitamins were prescribed. The CVF were examined before and after treatments. Results: The recovery time of visual acuity in laser group was 33 88 (11 71 days, the CVF in 22 eyes (84.62%) recovered completely. In the rest eyes of the subject group the more times of re-occurrence, the more abnormal CVF remained after laser. The recovery time of visual acuity in self-cured group were 126.67 ( 38.22 days. The courses and mean sensitivities of the two groups were different significantly (P<0.05), while in recovery time there was no difference. Conclusions: The abnormal CVF remained seems related to the times of re-occurrence. Proper laser is of no CVF defect.