Refractive State and Macular Abnormalities at Oct in Albino at Chu Iota

Introduction: A rare genetic disease, albinism is globally characterized by specific deficits of the visual system associated with a variable hypopigmentation phenotype depending on the disruption of melanin production [1]. It is linked to a hereditary defect in the biosynthesis of melanin. Disease results in a generalized decrease in the pigmentation of the appendages, skin and eyes [2]. The aim of this study is to determine the different refractive errors and the different macular anomalies during the OCT examination in oculocutaneous albinism at the CHU-IOTA. Patients and Method: We conducted a prospective study in patients over 10 years of age with oculocutaneous or ocular albinism who consulted at the CHU-IOTA between July 1, 2020, and September 30, 2021. Results: Over the period, 105 cases of oculocutaneous albinism were collected out of a total of 42,024 consultations, which corresponds to a frequency of 0.2%. The average age was 26.2 years, (11 years to 48 years). The sex ratio was 1.6. Astigmatism was the most found refractive error in 50.48% of cases, followed by myopia in 29.52% of cases and farsightedness in 20% of cases. The macular thickness between 251 - 350 was the most commonly found in both eyes, i.e. 47.25% on the right and 53.55% on the left. The bulging macula was the most frequent pathology on the OCT at the level of the two eyes, i.e. 41.42% on the right and 50.6% on the left. Conclusion: Following the visual impairments linked to albinism, early optical care and access to OCT are necessary. Thus the accompaniment of a subject with albinism and associations of albinism must be global and meet specific needs, in order to prevent or avoid ocular complications.

The vitreomacular interface in different types of agerelated macular degeneration

AIM： To evaluate the vitreomacular interface in cases with wet age-related macular degeneration（AMD） and to compare them to eyes with dry AMD and normal eyes.METHODS： This was a cross-sectional comparative study that included 87 eyes with wet AMD,42 eyes with dry AMD and 40 eyes without AMD as a control group.Optical coherence tomography（OCT） examination was performed for all patients to assess the vitreomacular interface.RESULTS： In the wet AMD group,34.5% of cases had vitreomacular adhesion（VMA）.Only 14.3% of dry AMD cases and 10% of control cases had VMA.There was a significant difference between the control group and the wet AMD group（P=0.004） as well as the dry and wet AMD group（P=0.017）.There was also a significant difference between the incidence of VMA in patients with subretinal choroidal neovascularization（CNV,type 1） and intraretinal CNV（type 2 or type 3）（P=0.020）.CONCLUSION： There is an association between posterior vitreous attachment and AMD.There is also an increased incidence of VMA with intra-retinal CNV.

Comparison of persistent submacular fluid in different preoperative macular status after vitrectomy for rhegmatogenous retinal detachment

AIM： To compare the incidence of persistent submacular fluid（SMF） and visual outcome after pars plana vitrectomy（PPV） for rhegmatogenous retinal detachment（RRD） in different preoperative macular status according to optical coherence tomography（OCT）.METHODS： A non-randomized, retrospective review was performed for patients who underwent successful PPV for RRD. OCT exams were taken preoperatively and 1 mo after surgery, until SMF disappeared. According to the preoperative macular status on OCT, patients were divided into two groups： macula-off RRD（Group A） and maculaon RRD（Group B）. In Group A, there were two subgroups： macula partly detached（Group A1） and macula totally detached（Group A2）. The main outcome measures were the presence of SMF on OCT 1 mo after surgery, and the preoperative and postoperative best corrected visual acuities（BCVA）, among the different groups and depending on the presence or absence of persistent SMF.RESULTS： A total of 139 eyes of 139 patients were included in the study. Persistent SMF at 1 mo after surgery was 15.8%（22/139）, all occurring in Group A（22/101）; Group B had no SMF at 1 mo after surgery（0/38, P=0.002）. The incidence of persistent SMF at 1 mo after surgery in Group A1 was 50%（14/28）, and in Group A2 was 11.0%（8/73, P〈0.001）. Significant differences were shown between the presence and absence of persistent SMF on foveolaoff RRD, the preoperative BCVA, the 1 mo postoperative BCVA, and the degree of the BCVA improvement from 1 mo postoperatively to the final follow-up（P〈0.05）. However, there were no significant differences in the final BCVA（P〉0.05）.CONCLUSION： Persistent SMF after PPV for retinal detachment is associated with preoperative macular status. Macula-uninvolving RRD shows no persistent SMF after PPV. Macular partly detached RRD has a higher incidence of SMF than macula totally detached RRD after PPV. The persistence of SMF may be responsible for the delayed visual recovery, whereas there were no significant differences in the final visual acuity.

Evaluation of peripapillary retinal nerve fiber layer, macula and ganglion cell thickness in amblyopia using spectral optical coherence tomography

AIM:To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS:Thirty six patients with a history of unilateral amblyopia and thirty two children who had emmetropia without amblyopia were included in this study. In this institutional study, 36 eyes of 36 patients with amblyopia (AE), 36 fellow eyes without amblyopia (FE), and 32 eyes of 32 normal subjects (NE) were included. RNFL, GCC and macular thickness measurements were performed with RS-3000 OCT Retina Scan (Nidek Inc CA. USA). RESULTS:The mean global thicknesses of the RNFL were 113.22 ±21.47, 111.57 ±18.25, 109.96 ±11.31μm in the AE, FE, and NE, respectively. There was no statistically significant difference for mean global RNFL thickness among the eyes (P =0.13). The mean thicknesses of the macula were 258.25±18.31, 258.75±19.54, 248.62±10.57μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of macula among the eyes (P =0.06). The GCC was investigated into two parts:superior and inferior. The mean thicknesses of superior GCC were 102.57 ±13.32, 103.32 ±10.64, 100.52 ± 5.88μm in the AE, FE, and NE, respectively. The mean thicknesses of inferior GCC were 103.82 ±12.60, 107.82 ± 12.33, 105.86±10.79μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of superior and inferior GCC between the eyes (P =0.63, P =0.46). ·CONCLUSION:The macular thicknesses of AE and FE were greater than the NE, although it was not statistically significant. Amblyopia does not seem to have a profound effect on the RNFL, macula and GCC.

A hypothesis for treating inflammation and oxidative stress with hydrogen sulfide during age-related macular degeneration

Age-related macular degeneration（AMD） is a leading cause of blindness and is becoming a global crisis since affected people will increase to 288 million by 2040.Genetics,age,diabetes,gender,obesity,hypertension,race,hyperopia,iris-color,smoking,sun-light and pyroptosis have varying roles in AMD,but oxidative stress-induced inflammation remains a significant driver of pathobiology.Eye is a unique organ as it contains a remarkable oxygengradient that generates reactive oxygen species（ROS） which upregulates inflammatory pathways.ROS becomes a source of functional and morphological impairments in retinal pigment epithelium（RPE）,endothelial cells and retinal ganglion cells.Reports demonstrated that hydrogen sulfide（H2S） acts as a signaling molecule and that it may treat ailments.Therefore,we propose a novel hypothesis that H2S may restore homeostasis in the eyes thereby reducing damage caused by oxidative injury and inflammation.Since H_2S has been shown to be a powerful antioxidant because of its free-radicals＇ inhibition properties in addition to its beneficial effects in age-relatedconditions,therefore,patients may benefit from H2S salubrious effects not only by minimizing their oxidant and inflammatory injuries to retina but also by lowering retinal glutamate excitotoxicity.

Surgical Management of Macular Epiretinal Membranes

Purpose: To evaluate the effects of surgical treatment on macular epiretinal membranes.Methods: Vitrectomy and membrane removal were undergone for idopathic or secondary macular epiretinal membrane.Results: Fourteen eyes of 15 patients (93%) had vision improvement after operation in which 8 eyes (57%) increased 3 or more Senellen lines. Only one case suffered from paracentral scotoma. No other complications were noted. Conclusion: Surgical management of macular epiretinal membrane is safe and effective with good visual outcome and few complications. Eye Science 1996; 12:140 -144.

Characteristics of the macula in amblyopic eyes by optical coherence tomography

AIM: To test the hypothesis that amblyopic neuroretina may have an altered thickness when compared to the normal. METHODS: Twenty-five amblyopic, young patients between the ages of 7 and 11 years old were studied. The interested neuroretina areas are defined into 10 sub-regions according to superior-inferior, nasal-temoral, and pen-para axis, which cross the fovela structure. The thicknesses of ten, defined macular regions were separately measured by optical coherence tomography (OCT) and analyzed by ttest. RESULTS: The average thickness of neuroretina in the exact foveola of the amblyopic eyes is larger than that of normal eyes (P<0.05), but the other nine regions have no significant difference. Interestingly, in both the normal and amblyopic eyes, the temporal area looks thinner than other quadrants (P<0.05). CONCLUSION: Thickness alteration may be associated with amblyopic disorders in young patients. Studying a larger volume of subjects of similar age is required to confirm this observation.

Effect of femtosecond laser-assisted lens surgery on the optic nerve head and the macula

AIM: To evaluate the effect of femtosecond laser-assisted lens surgery(FLALS;cataract surgery or refractive lens exchange) on the structure of the optic nerve head and the macula.METHODS: This prospective longitudinal study included healthy eyes undergoing FLALS. Eyes with glaucoma or any other ocular disease that could alter optical coherence tomography results were excluded. Retinal nerve fiber layer(RNFL), Bruch’s membrane opening-minimum rim width(BMO-MRW) and macular thickness(MT) were measured preoperatively, 1 and 6 mo after surgery using spectral-domain optical coherence tomography(SD-OCT). Changes between preoperative and postoperative values were evaluated.RESULTS: A total of 87 eyes of 46 patients were included in this study. Preoperative RNFL, BMO-MRW and MT in microns(μm) were 100.77±10.39, 330.31±49.99 and 276.30±33.39, respectively. Postoperative RNFL, BMO-MRW and MT were 104.74±11.55, 348.32±54.05 and 279.83±22.65 1 mo after surgery and 102.93±11.17, 343.11±53.4 and 278.90±22.19 6 mo after surgery, respectively;which equals an increase of 3.93%, 5.45% and 1.27%,respectively, 1 mo after surgery, and 2.14%, 3.87% and 0.94% 6 mo after surgery. The differences between the preoperative and the postoperative RNFL and BMO-MRW values were statistically significant(P<0.001). Regarding MT values, there were not statistically significant differences(P=0.26).CONCLUSION: Our study suggests that FLALS does not have a negative impact on the structural status of the optic nerve head in healthy eyes, assessed by SD-OCT. There is a slight increase in the values of RNFL, BMO-MRW and MT 1 mo and 6 mo after surgery.

Spontaneous resolution of macular edema after silicone oil removal

AIM: To investigate the macular changes in eyes filled with silicone oil(SO) and course of these changes after SO removal. METHODS: A retrospective optical coherence tomography scan review was conducted for twenty-four patients who underwent uncomplicated pars plana vitrectomy with SO tamponade for complex retinal detachments were detected with optical coherence tomography before, and one week, one month and three months after SO removal.RESULTS: Mean duration of SO tamponade was 3.6±1.0mo(range 3-7mo). Cystoid macular edema(CME) was detected in 3 eyes before SO removal. Submacular fluid was represented in 1 eye before silicone SO removal.Resolution of CME and submacular fluid was achieved1 mo after SO removal in all eyes. Mean best corrected visual acuity(BCVA) was 1.15 ±0.65(range, hand movement to 0.2) before SO removal in the eyes without macular changes. After SO removal, the mean BCVA values at 1wk and 1 and 3mo, and 0.82 ±0.23, 0.76 ±0.21,and 0.70 ±0.19, all of which were significantly better than baseline(P =0.030, 0.017, 0.006 respectively). In the eyes with macular CME and subretinal fluid the mean BCVA was significantly improved at 3mo after SO removal compared with baseline(P =0.037).CONCLUSION: Decreased visual acuity in eyes filled with SO could be caused by macular complications due to SO. CME and subretinal fluid may resolve without any additional macular surgery after SO removal.

Classification of Diabetic Macular Edema and Its Stages Using Color Fundus Image

Diabetic macular edema （DME） is a retinal thickening involving the center of the macula. It is one of the serious eye diseases which affects the central vision and can lead to partial or even complete visual loss. The only cure is timely diagnosis, prevention, and treatment of the disease. This paper presents an automated system for the diagnosis and classification of DME using color fundus image. In the proposed technique, first the optic disc is removed by applying some preprocessing steps. The preprocessed image is then passed through a classifier for segmentation of the image to detect exudates. The classifier uses dynamic thresholding technique by using some input parameters of the image. The stage classification is done on the basis of anearly treatment diabetic retinopathy study （ETDRS） given criteria to assess the severity of disease. The proposed technique gives a sensitivity, specificity, and accuracy of 98.27%, 96.58%, and 96.54%, respectively on publically available database.

Challenges in studying geographic atrophy(GA) age-related macular degeneration: the potential of a new mouse model with GA-like features

Loss of central vision critical to everyday activities such as reading,face-recognition and driving due to damage in the central retina (the macula) is the leading cause of irreversible blindness amongst adults in the developed world.This condition,termed age-related macular degeneration (AMD),is a complex,chronic degenerative disease driven by a combination of genetic and lifestyle risk factors.Early signs of retinal changes in people as young as 30–40 years have been reported,although these individuals appear to be asymptomatic.However,by the age of 65,the disease is present in ~3% of individuals,which increases dramatically to affect 1/3 of individuals by the eighth decade of life.Early to intermediate AMD is estimated to affect ~150 million individuals globally,with another 10 million individuals suffering from end-stage,sight-threatening forms.These terminal stages are broadly grouped into dry (geographic atrophy,GA) or wet (choroidal neovascular,CNV) AMD (Sarks et al.,1988;Bird et al.,2014),with similar frequencies reported in patients.Recent advances in identifying genetic risk factors,including our discoveries in this field,indicate an initial shared pathology before progressing to aforementioned late-stage phenotypes.Currently,GA patients have no effective treatment,which may in part be due to the lack of good in vivo models for GA studies.Here,we summarize our new findings that describe an altogether new mouse model with GA-like features which shows progressive outer retinal pathology (Ibbett et al.,2019) that can be used to gain novel insights into GA and potentially as a tool for drug development.

Automatic localization of macular area based on structure label transfer

AIM： To explore feasibility and practicability of macula localization independent of macular morphological features. METHODS： A novel method was proposed to identify macula in fundus images by using structure label transfer. Its main idea was to match a processed image with the candidate images with known structures, and then transfer the structure label representing the macular to the processed image as a result of macula localization. In this way, macula localization couldn＇t be influenced by lesion or other interference any more. RESULTS： The average success rate in four datasets was 98.18%. For accuracy, the average error distance in four datasets was 0.151 optic disc diameter （ODD）. Even for severe lesion images, the proposed method can still maintain high success rate and high accuracy, e.g., 95.65% and 0.124 ODD in the case of STARE dataset, respectively, which indicated that the proposed method was highly robust and stable in the complicated situations. CONCLUSION： The proposed method can avoid the interference of lesion to macular morphological features in macula localization, and can locate macula with high accuracy and robustness, verifying its feasibility.

A pilot study on vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis——2y follow-up results

AIM:To evaluate the effect of vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis.METHODS:Thirty-seven patients with myopic macular retinoschisis who underwent pars plana vitrectomy(PPV)combined with scleral shortening were reviewed.Axial length(AL),the height of macular retinoschisis,the height of retinal detachment if existed,the diameter of macular hole if existed and best corrected visual acuity(BCVA)were obtained.The preoperative and postoperative parameters were compared.RESULTS:At postoperative 24 mo,the mean AL and height of macular retinoschisis were reduced significantly by 0.79 mm and 256.51μm(t=8.064,P<0.0001;Z=-5.086,P<0.0001)respectively.In addition,the mean height of retinal detachment and diameter of macular hole were also reduced significantly by 365.38μm and 183.68μm(Z=-4.457,P=0.000008;Z=-2.983,P=0.003)respectively.Meanwhile,the postoperative BCVA was improved markedly(Z=-2.126,P=0.033).CONCLUSION:Vitrectomy combined with scleral shortening is an effective surgical method for eyes with myopic macular retinoschisis,whether or not macular hole and retinal detachment are present.

Unilateral focal lesions in the macula as an early presentation of syphilis

A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity(BCVA) was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both eyes were normal. Yellowish-white focal lesions in the macula of the right eye were observed and subtly changes of lesions were found along the superotemporal and inferotemporal arcades in the macula two days later. Fluorescein fundus angiography(FFA) revealed slight fluorescent leakage from the lesions in the macula of the right eye, and segmental venous leakage and optic disc hyperfluorescence were observed in both eyes. Indocyanine green angiography(ICGA) demonstrated that the lesions in the macula of the right eye had hypofluorescence at a late stage and spectral domain optical coherence tomography(SD-OCT) imaging of the macula showed focal impairment of the inner segment and outer segment(IS/OS). The blood investigation indicated a positive treponema pallidum hemagglutination assay(TPPA) and a rapid plasma reagin test(RPR) of 1:32. After antisyphilitica treatment for 6 weeks, the yellowish-white lesions had vanished and the BCVA was 1.2 followed by restoration of the IS/OS for the right eye, with an RPR of 1:4. In conclusion, ophthalmologists should alert unilateral focal lesions in the macula may be the first sign of syphilis. Prompt treatment is highly effective in resolving vision.

Dome-Shaped Macula and Foveal Neurosensory Retinal Detachment—A Case Series

Objective: To report a case series of dome-shaped macula (DSM) and serous retinal detachment (SRD). Methods: A retrospective and observational case series study was performed at two centers of ophthalmology in Rosario-Argentina from January 2016 to December 2017. Eight eyes of 5 patients diagnosed with dome-shaped macula with subfoveal hyporeflective zone seen in optical coherence tomography (OCT) were included. Best-corrected visual acuity (BCVA), OCT, fluorescein angiography (FA), differential diagnoses, clinical course and different treatments were reviewed. Results: Baseline visual acuity ranged from 20/25 to 20/200. OCT revealed that the retinal choroidal macular complex had a convex shape and exhibited foveal neurosensory retinal detachment in all cases. FA showed mild diffuse hyperfluorescence due to changes in the retinal pigment epithelium (RPE). No sign of leakage was observed. Different treatments were used, including intravitreal antiangiogenic drugs, oral spironolactone, melatonin and observation. Follow-up time was between 6 and 18 months. BCVA and OCT findings remained unchanged after different options of treatment. Conclusions: DSM is an unusual entity, which can be confused with other maculopathies that cause neurosensory retinal detachment and do not respond to different types of treatment. Hence, in our opinion, observation is a reasonable approach for this disorder.

Managing Macular Holes in a Developing Economy

Background: Macular holes are the common cause of visual impairment especially in the elderly and have a variety of etiological factors. The advances in the management of macular holes are encouraging and are now available in developing countries although scarce, where hitherto;patients seek attention outside their country. The need to understand this disease has therefore become pertinent in all retina clinics. Objective: To evaluate the pattern of presentation of macular holes and its management in a retina clinic in South South Nigeria. Methods: A 5 year retrospective, non comparative review of 24 consecutive cases presenting to a retinal clinic was carried out. Relevant information was extracted from the medical records and analyzed. Results: Three hundred and sixty four cases were seen between January 2009 and December 2013. Twenty four cases had macular holes and ten (41.7%) had bilateral presentation with a total of 34 eyes. The incidence of macular holes was 6.6%. The mean age was 46 years (SD ± 13.42) with a female preponderance, 5:1. Idiopathic holes formed the bulk of the cases 14(58.3%);others were trauma 4(16.7%), posterior uveitis 2, (8.3%), chemotherapy 2 (8.3%), Solar retinopathy and retinitis pigmentosa 1 (4.2%). Nineteen (55.9%) of the 34 eyes were visually impaired (BCVA <6/18). Nineteen eyes had full thickness holes (55.9%) requiring surgery, however only 3(12.5%) of these could afford to have surgery with one reoperation. Four patients (16.7%) had complications in form of retinal detachments at presentation. Conclusion: This study has shown that the incidence of macular holes in the developing world is significant and resources to manage these cases are grossly lacking. Specialist training, with government subsidizing costs will alleviate these difficulties and reduce visual loss from macular holes.

Bilateral Macular Hemorrhage Revealing Severe Thrombocytopenia in an AIDS Context about a Case Report

We report the clinical observation of an HIV-positive/AIDS patient with bilateral macular hemorrhage, which resulted in the identification of severe thrombocytopenia. Thrombocytopenia is a common hematologic anomaly during HIV infection. Its frequency increases with the decrease in CD4 T lymphocytes and the passage to the AIDS stage. Its pathophysiology in this context is complex and multifactorial. Hemorrhagic complications usually appear for platelets less than 50,000/mm3 and this risk is greater at a rate of less than 20,000/mm3. Retinal hemorrhages may go unnoticed, only macular localization results in clinical expression. OCT is of paramount importance in accurate topographic diagnosis of macular hemorrhages by locating their seats which can be pre, intra or under retinal. Management requires the balance of infectious and hematologic factors. Ophthalmic surgical treatments should be considered in a second step.

Herniation of the Retina in the Central Macula in an Adult after Iridocyclitis

Purpose:To report an unusual case of retinal hernia in the central macula in an adult after iridocyclitis.Case report:.We report a case of a 46-year-old male who presented with blurred vision 2 weeks after complete resolution of acute iridocyclitis. Anterior segment and vitreous body examinations were unremarkable. Yellowish spots in the macular area were observed. Spectral domain optical coherence tomography(SD-OCT) imaging of the macula showed loss of the inner segment / outer segment(IS / OS) photoreceptor junction,.with irregularity of the retinal pigment epithelium(RPE),.and a V-shaped hernia of the retina into the choroid.The macular lesions emerged as mild window defects on fluorescein angiography and were visualized as hypofluorescent patches on all-phase indocyanine green angiography. At a one month follow-up, the best-corrected visual acuity improved to20 / 20,.which was followed by partial restoration of the IS / OS line,.but a V-shaped hernia of the retina remained unchanged on SD-OCT.Conclusion:.Ophthalmologists should be alert to the changes in OCT of the macula in patients after iridocyclitis and further research on the cause and possible predisposing factors for retinal herniation is warranted.

青年人近距离阅读纸质及电子文本对黄斑区微循环的短期影响

目的探讨持续近距离阅读相同内容的纸质文本和电子文本对健康青年人黄斑区微循环产生的短期影响。方法前瞻性使用光学相干断层扫描血管成像(OCTA)测量2021年5—10月就读于潍坊医学院的30名(60眼)健康在校大学生阅读纸质文本和电子文本1 h前后,黄斑区浅层视网膜血流密度(SVD)、深层视网膜血流密度(DVD)及脉络膜血流密度(CVD)和黄斑中心凹下脉络膜厚度(SFCT)的变化并进行对比。结果经过量化分析,阅读纸质文本1 h,SVD在中心凹的下降[(18.3±7.4)%,(17.4±7.2)%]和旁中心凹下方区域的下降[(50.2±4.2)%,(48.0±5.5)%],差异有统计学意义(Z=2.93,P=0.021;Z=3.25,P=0.007);在其他的采集区域中,干预前后SVD的改变差异无统计学意义(P>0.05)。阅读电子文本1 h后,CVD下降[(75.8±4.1)%,(74.7±4.9)%](t=2.36,P=0.022);SFCT下降(289.0±6.2,280.7±6.6)(t=2.35,P=0.022)。结论持续近距离阅读纸质文本1 h,会引起黄斑区浅层视网膜血流在短期内下降;持续近距离阅读电子文本1 h,会引起黄斑区脉络膜血流在短期内下降。这会增加一些眼底疾病的发病率。

皮肤针叩刺联合局部注射氨甲环酸治疗黄褐斑临床观察

目的 探究皮肤针叩刺结合局部注射氨甲环酸对黄褐斑的治疗效果。方法 于2020年8月—2022年8月在南京中医药大学江阴附属医院医疗美容科门诊诊治的黄褐斑患者中选择性选取68例作为此次观察对象,均分为单纯治疗组(仅皮肤针叩刺)和联合治疗组(皮肤针叩刺联合局部注射氨甲环酸),半个月操作1次,3次为1个疗程,3个疗程后察看色素改善情况及不良反应。结果 3个疗程后,联合治疗组总有效率94.1%(32/34)明显高于单纯治疗组的70.6%(24/34),差异有统计学意义(P<0.05)。2组均未见不良反应发生。结论 联合治疗组治疗效果优于单纯治疗组,可明显减轻色沉和缩小色斑范围,且无不良反应。