摘要
目的 评估并比较50％滴定能量（TP）的577 nm阈值下微脉冲光凝（SMLP）与25％TP的577 nm SMLP治疗急性中心性浆液性脉络膜视网膜病变（CsC）的短期疗效.方法 前瞻性非随机对照研究.纳入2014年12月至2016年6月在中山大学中山眼科中心就诊且符合入选标准的单眼急性CSC患者94例（94眼）,给予50％的TP-SMLP治疗（50％TP-SMLP组）或者25％的TP-SMLP治疗（25％TP-SMLP组）.治疗前及治疗后1个月均行最佳矫正视力（BCVA）和频域光学相干断层扫描检查（SD-OCT）.通过t检验或秩和检验评估BCVA（LogMAR）及黄斑中心凹厚度（CMT）的改变及2组之间的差异,卡方检验比较2组治疗后视网膜下积液（SRF）完全吸收率.结果 50％TP-SMLP组共纳入55例患者（男性82％）,治疗前BCVA为（0.34±0.25）LogMAR,治疗后1个月为（0.12±0.21）LogMAR（t=8.557,P＜ 0.001）;治疗前CMT为（461±168）μm,治疗后1个月为（227 ±82） μm（t=10.332,P＜0.001）.25％TP-SMLP组共纳入39例患者（男性92％）,治疗前BCVA为（0.35±0.25）LogMAR,治疗后1个月为（0.24±0.22） LogMAR（t=3.759,P=0.001）;治疗前CMT为（471±170）μm,治疗后1个月为（298±97）μm（t=6.610,P＜0.001）.组间比较显示在治疗1个月后,50％TP-SMLP组在提高BCVA（t=2.850,P=0.005）及降低CMT（Z=-3.787,P＜0.001）方面均显著好于25 ％TP-SMLP组.治疗后1个月50％TP-SMLP组及25％TP-SMLP组的SRF完全吸收率分别为71％与26％（x2=18.738,P＜0.001）.结论 50％TP-SMLP与25％TP-SMLP治疗急性CSC后1个月均可显著改善患者的BCVA、CMT,促进SRF吸收,且50％ TP-SMLP的疗效更好.
Objective To evaluate and compare the short-term effects of 25% and 50% titration power （TP） in subthreshold micropulse laser photocoagulation （SMLP） for acute central serous chorioretinopathy （CSC）.Methods This was a prospective,non-randomized,controlled study.Ninety-four patients （94 eyes） attending Zhongshan Ophthalmic Center with acute CSC from Dcccmber 2014 to June 2016 were enrolled.The patients were treated with either 25%TP-SMLP or 50%TP-SMLP.Best-corrected visual acuity （BCVA）,fundus photography,fundus spectrum-domain optical coherence tomography （SD-OCT）,were performed on every patient before treatment.The patients were re-examined for BCVA and by SD-OCT at the one-month follow-up.Changes in the logarithm of the minimum angle of resolution （LogMAR） of BCVA,central macular thickness （CMT）,and rate of complete absorption of subretinal fluid （SRF）,were evaluated by t-test or rank sum test and chi-square test.Results Fifty-five patients （82% males） and 39 patients （92% males） were included in the 50%TP-SMLP and 25%TP-SMLP groups,respectively.One month after the 50%TP-SMLP treatment,the BCVA improved （t=8.557,P〈0.001） while the CMT decreased （t=10.332,P〈0.001）.One month after the 25%TP-SMLP treatment,both the BCVA and the CMT decreased （t=3.759,P〈0.001 and t=6.610,P〈0.001,respectively）.The improvement in BCVA （t=2.850,P=0.005） and decrease in CMT （Z^3.787,P〈0.001） were considerably better in the 50%TP-SMLP group than that in the 25%TP-SMLP group.At one month after treatment,complete absorption of SRF occurred in 71% and 26% of the eyes in the 50% and 25%TP-SMLP groups,respectively （x2=18.738,P〈0.001）.Conclusion Both 25% and 50%TP-SMLP can significantly improve BCVA,reduce CMT,and accelerate the absorption of SRF for acute CSC.However,the effect of 50%TP-SMLP is much better than that of 25%TP-SMLP.
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2017年第2期120-124,共5页
Chinese Journal Of Optometry Ophthalmology And Visual Science
