氩激光治疗中心性浆液性视网膜脉络膜病变的临床研究

Clinical study of argon laser photocoagulation for central serous chorioretinopathy

目的分析氩激光治疗中心性浆液性视网膜脉络膜病变(中浆)的临床效果.方法选择经眼底荧光血管造影显示有明确渗漏点,其渗漏点距黄斑中心凹500μm以外的中浆患者102例102眼,采用氩绿激光行渗漏点直接光凝封闭,激光参数:光斑直径100～200μm,爆光时间0.2 s,能量80～150mW.激光光凝1次或2次补充完成.结果激光光凝后视力迅速提高一行以上者95眼,视力无变化7眼;眼前黑影、视物变形症状消失的87眼;两周内视网膜神经上皮盘状脱离消失,中心凹反光出现的80眼;首次光凝未完全封闭渗漏点需2次补充光凝的4眼;治疗过程中无1例因光凝损伤黄斑中心凹;全部患者激光光凝后随访6个月至5年,未发现远期光凝并发症,同时无1例复发.结论氩激光治疗中浆可较快提高视力、缩短病程、减少复发率,把握光凝条件是杜绝光凝并发症的关键.

Objective Toevaluatetheclinicaleffectofargonlaserphotocoagulationforcentralserouschorioretinopthy.Methods This study included 102 consecutive cases of central serous chorioretinopathy (102 eyes) with fluorescein dyeleakage located 500 μm away from the central fovea of the macula lutea as defined by fundus fluorescein angiography (FFA).Argon laser photocoagulation of the leakage spots was performed once (98 eyes) or twice (4 eyes) with the spot diameter forexposure ranging from 100 to 200 μm and exposure time of 0.2 s that delivered energy of 80 to 150 mW. Results The visualacuity was improved in 95 cases by one row on the standard vision chart within 2 or 3 d after the laser treatment, while in theother 7 cases, the visual acuity remained unchanged. The symptoms of micropsia, metamorphopsia and blurred visiondisappeared in 87 cases. Serous detachment of the sensory retina and the fovea light reflex recovered in 80 cases within twoweeks after the treatment and no fovea injuries due to photocoagulation were recorded. During the follow-up lasting for 6 to 12 months no recurrence or long-term complications in relation with photocoagulation treatment were observed in these cases.Conclusion Argon laser photocoagulation is effective for central serous choiroretinopathy, and strict control of the photocoa-gulation conditions is crucial for preventing complications in relation to laser coagulation.