经瞳孔温热疗法治疗旁中心凹渗漏点的中浆
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Transpupillary thermotherapy for central serous chorioretinopathy with parafoveal leaks
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    摘要:

    目的:观察经瞳孔温热疗法(transpupillary thermotherapy,TTT)治疗渗漏点位于旁中心凹的中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC,简称中浆)患者的临床效果。

    方法:采用TTT治疗经眼底荧光造影和光学相干断层扫描检查确诊并自愿选择TTT治疗的患者19例23眼,其中男17例,女2例; 左眼9只,右眼14只。年龄32~52(平均44.00±4.973)岁。我们运用810红外激光进行TTT治疗。随访所有患者TTT治疗后1,2,6mo的视力(Snellen视力表转换成LogMAR以便分析)、眼底检查、眼底荧光造影、光学相干断层扫描等。

    结果:在接受治疗1mo后眼底荧光造影显示渗漏消失者14眼(61%),光学相干断层扫描显示神经上皮无脱离; 在治疗2mo后渗漏消失、神经上皮脱离愈合者21眼(91%); 6mo后23眼全部无渗漏、无神经上皮脱离。74%的患者在6mo后视力提高≥3行。治疗后2mo时FFA显示渗漏点消失,OCT显示视网膜下液吸收且视力无下降者视为治疗成功,治疗后6mo时视网膜下液仍持续存在且视力无改善者则视为治疗失败。

    结论:TTT治疗旁中心凹渗漏的CSC在短期内安全有效,可能通过缩短病程改善CSC 的预后。

    Abstract:

    AIM:To explore the clinical effect of transpupillary thermotherapy(TTT)for the treatment of central serous chorioretinopathy(CSC)with parafoveal leaks.

    METHODS: Twenty-three eyes from nineteen patients with long-standing CSC and parafoveal leaks(50-200μm around the fovea)who opted for TTT and observation were enrolled in this study. Eighteen of nineteen patients(23 eyes)were male, fourteen of twenty-three eyes were right eyes. The patients' mean age was 44.00±4.973 years(range from 32-52 years). TTT was performed using 810nm infrared diode laser. All patients underwent Snellen visual acuity measurement(converted to LogMAR for analysis)fundus examination, fluorescein angiography(FFA)and optical coherence tomography(OCT). Follow-up was scheduled at 1, 2, 6mo.

    RESULTS:Following treatment of TTT, complete resolution of neurosensory detachment on OCT and disappearance of leakage on FFA was seen in fourteen eyes(61%), twenty-one eyes(91%)at the 2mo and twenty-three eyes(100%)at the 6mo respectively. A total of 74% had ≥3 lines of improvement after 6mo. Success was defined as resolution of neurosensory on OCT and disappearance of leakage on FFA at the 2mo. Failure was defined as no change at the 6mo and no improvement of visual acuity.

    CONCLUSION:TTT is safe and effective therapeutic option in patients with CSC and parafoveal leaks. It may improve the visual acuity by shortening the persistent serous elevation of the macula.

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肖庆,曾军,唐罗生,等.经瞳孔温热疗法治疗旁中心凹渗漏点的中浆.国际眼科杂志, 2014,14(4):755-759.

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  • 收稿日期:2013-12-13
  • 最后修改日期:2014-03-17
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  • 在线发布日期: 2014-03-24
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