急性与慢性中心性浆液性脉络膜视网膜病变微视野检查结果对比分析

Comparative analysis of microperimetry in acute and chronic central serous chorioretinopathy

目的 观察急性与慢性中心性浆液性脉络膜视网膜病变（CSC）微视野改变.方法 横断面观察性病例研究.临床检查确诊的CSC患者208例221只眼纳入研究.根据病程和荧光素眼底血管造影检查结果将患者分为急性CSC组和慢性CSC组,分别为136例143只眼和72例78只眼.两组患者性别构成比（x2 =0.012）及平均年龄比较（t=-1.492）,差异均无统计学意义（P=0.912、0.137）.所有患眼均行最佳矫正视力（BCVA）及微视野检查.BCVA转换为最小分辨角对数（logMAR）视力进行统计.采用黄斑完整性评估仪测量黄斑10°区域平均光敏感度（MS）、黄斑中心凹2°（P1）及4°（P2）固视率,并评估固视稳定性.结果 急性、慢性CSC组患眼logMAR BCVA分别为0.32±0.23、0.48±0.33;两组患眼BCVA比较,差异有统计学意义（Z=-3.353,P=0.001）.急性、慢性CSC组患眼MS值分别为（21.25±5.06）、（15.82±7.23） dB;P1分别为（76.36±25.78）％、（55.01±32.34）％;P2分别为（92.21±13.06）％、（79.83±23.11）％.两组患眼MS值（Z=-5.456）、P1（Z=-4.629）、P2（Z=-4.265）比较,差异均有统计学意义（P＜0.001）.急性CSC组143只眼中,固视稳定98只眼,占68.5％;固视相对不稳定30只眼,占21.0％;固视不稳定15只眼,占10.5％.慢性CSC组78只眼中,固视稳定30只眼,占38.5％;固视相对不稳定22只眼,占28.2％;固视不稳定26只眼,占33.3％.两组患眼固视稳定性比较,差异有统计学意义（x2=23.196,P＜0.001）.结论 与急性CSC患眼比较,慢性CSC患眼MS、固视率及固视稳定性均降低.

Objective To investigate the difference in microperimetry between acute and chronic central serous chorioretinopathy （CSC）.Methyds Cross-sectional cases study.A consecutive series of 208 patients （221 eyes） with CSC diagnosed by fundus fluorescein angiography （FFA） and optical coherence tomography （OCT） were enrolled in the study.The patients were divided into acute group （136 patients,143 eyes） and chronic group （72 patients,78 eyes） according to the duration and FFA.There were no statistical difference in sex （x2 =0.012,P=0.912） and mean age （t=-1.492,P=0.137） between two groups.All eyes received the examination of microperimetry and minimum resolution angle in logarithmic （logMAR） best corrected visual acuity （BCVA）.The mean retinal sensitivities （MS） and fixation rate in the central 2°（P1）and 4° （P2） were determined.Results The mean value of logMAR BCVA in acute group and chronic group were 0.32 ± 0.23 and 0.48 ± 0.33,there was significant difference （Z=-3.353,P =0.001）.In acute group and chronic group,the MS were （21.25±5.06） and （15.82±7.23） dB,P1 were （76.36±25.78）% and （55.01±32.34）%,P2 were （92.21±13.06）% and （79.83±23.11）%.There were statistical differences in MS （Z=-5.456,P〈0.001）,P1 （Z=-4.629,P〈0.001） and P2 （Z=-4.265,P〈0.001） between two groups.In acute group,fixation was stable in 98 eyes （68.5%）,relative unstable in 30 eyes （21.0 %）,unstable in 15 eyes （10.5 %）.In chronic group,fixation was stable in 30 eyes （38.5%）,relative unstable in 22 eyes （28.2%）,unstable in 26 eyes （33.3%）.The difference of fixation between two groups was statistically significant （x2 =23.196,P〈0.001）.Conclusion MS,fixation rate and fixation stability in chronic CSC eyes were all decreased compared with acute CSC eyes.