中心性浆液性脉络膜视网膜病变激光治疗后的对比敏感度特点

Contrast sensitivity measured in patients with central serous chorioretinopathy after laser photocoagulation

目的测量和观察急性中心性浆液性脉络膜视网膜病变（CSC）经视网膜激光光凝（LP）治疗后的对比敏感度（CS）恢复情况。方法前瞻性自身对照研究。临床确诊为单眼急性CSC的20例患者纳入本研究。其中，男17例，女3例，年龄32—49岁，平均（40．0±4．3）岁；均经荧光素钠眼底血管造影确诊为CSC且渗漏点位于黄斑中心凹无血管区外，LP治疗后第2个月和第6个月各随访1次，随访时测量CS、中心视网膜厚度（CRT）。首先比较患眼与对侧眼的测量值是否在正常曲线内，然后将患眼与对侧眼CS、CRT分别进行比较。患眼与对侧眼的数据比较采用配对t检验。结果LP治疗后第2个月，2例双眼对比敏感度均在正常范围内；18例患眼对比敏感度曲线低于正常范围。与对侧眼比较，患眼各空间频率均降低，差异有统计学意义（t=2．428、6．581、5．084、3．461，P〈0．05）；患眼CRT明显降低（t=5．784，P〈O．01）。第6个月随访，7例双眼对比敏感度均都在正常范围内；13例患眼对比敏感度低于正常范围；与对侧眼比较，患眼在6c／d、12c／d、18c／d空间频率CS降低，差异有统计学意义（t=2．236、3．359、3．404，P〈0．05）；患眼CRT低于对侧眼，差异有统计学意义（t=6．489，P〈0．01）。结论IJP治疗后视力恢复正常的急性CSC的患眼，第6个月中高频段对比敏感度仍然明显低于对侧眼，或者说其低对比度的形觉分辨力仍然低于正常。

Objective To investigate contrast sensitivity （CS） in patients with acute central serous chorioretinopathy （CSC） after laser photocoagulation （LP）. Methods This was a prospective self-controlled study. Twenty patients who were diagnosed with acute CSC in one eye were recruited for the study. Among these 20 subjects, there were 17 male and 3 female 40.0±4.3 years old （ranging from 32 to 49）. The affected eyes of patients were treated with LP if fundus fluorescene angiography revealed that a leakage lesion was outside of the foveal zone. Patients were followed at 2 and 6 months after LP treatment. The CS and central retinal thickness （CRT） were measured and compared between the affected eyes and the fellow eyes. Results Two months after LP treatment, CS curves were within the normal range in 4 eyes and out of the normal range in 18 eyes. Compared to the fellow eyes, the CS were significantly lower under all spatial frequencies （t=2.428, 6.581, 5.084, 3.461, P〈0.05）. The CRT of the affected eyes was significantly thinner than that for the fellow eyes （t=5.784, P〈0.01）. Six months after LP treatment, the CS curves were within the normal range in 14 eyes of 7 patients and out of the normal range in 13 eyes. The of the affected eyes was lower than that for the fellow eyes in the middle to high spatial frequencies （6, 12, and 18 c/d, t=2.236, 3.359, 3.404, P〈0.05）. The CRT of the affected eye was significantly thinner than the fellow eye （t=6.489, P〈0.01）. Conclusion Although visual acuity recovers to normal levels 6 months after LP in CSC eyes, CS remains significantly lower than that of the contralateral eye at middle to high spatial frequencies.