眼底自发荧光检查指导中浆激光治疗的临床研究

Clinical Study of Fluorescence in Laser Treatment to Inspect and Guide the Spontaneous Eye

目的观察中浆激光治疗前后自发荧光的改变,了解激光治疗对视网膜的损伤程度,指导中浆激光治疗时机的选择。方法门诊患者中疑似中浆诊断者常规行眼底荧光血管造影（FFA）和OCT检查,漏点位置距黄斑中心凹大于250μm者列入研究行列,拍眼底自发荧光照片。根据患者病程随机分为三组：病程〈3个月、病程3-6个月及病程〉6个月的患者。分别给予激光治疗。行激光治疗后分别观察第2周、4周、8周、半年、1年的视功能恢复情况,同时进行眼底自发荧光和OCT检查。结果各组均显示激光部位为点片状低荧光,急性中浆除激光造成局部点状低荧光外,余未见明显异常荧光。慢性中浆患者激光治疗后除点状低荧光外异常自发荧光未见消除或有加重现象。视力检查显示病程短者行激光治疗后明显优于慢性中浆患者。自发荧光检查提示急性中浆色素上皮损伤改变优于慢性中浆。结论激光治疗对视网膜色素上皮具有一定的损害;急性中浆进行激光治疗优于慢性中浆。

Objective To observe the changes in plasma before and after laser treatment of spontaneous fluorescence,laser treatment of retinal damage degree, guidance of slurry on the timing of laser treatment. Methods The clinic suspected in patients with plasma diagnosis in routine fundus fluorescence angiography（FFA） and OCT examination, funnelled position from the center of the macula concave included in the research category of greater than 250μm, fundus autofluorescence photographs. Course according to the patients were randomly divided into three groups： the course is less than 3 months, the course of the disease in 3-6 months and patients with more than 6 months duration. Laser treatment respectively. Patients after laser therapy were observed 2 weeks, 4 weeks, 8 weeks, 6 months, 1 year of visual function recovery, eyesight, funduscopic examination, fundus autofluorescence and OCT examination at the same time. Results Each group showed that laser parts for low bit patchy fluorescence and acute central serous chorioretinopathy in laser caused by low local punctate fluorescence, there was no more obvious abnormal fluorescence. The treatment of chronic central serous chorioretinopathy patients after laser in low abnormal autofluorescence punctate fluorescence was eliminated or worsening phenomenon. Visual examination showed that the short duration of the laser therapy was better than that of chronic patients. Autofluorescence examination showed acute serous pigment epithelium injury is better than chronic. Conclusion Laser therapy has certain damage to the retinal pigment epithelium; acute CSC laser treatment is better than chronic.