摘要
目的观察经瞳孔温热疗法(transpupillary thermal therapy,TTT)治疗中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy)(简称“中浆”)的疗效。方法治疗组采用半导体810nm红外激光对25例“中浆”患者的25只眼进行治疗。根据病灶大小选择光斑和能量。治疗后随访,如复发则进行重复治疗。对照组以荧光素钠试敏阳性者作为对照组,12例12眼,口服吸收剂、芦丁,维生素C。随访时间和检查项目同治疗组。结果以患者自诉Amsler表中心暗点及变形情况,最佳矫正视力,OCT测黄斑中心凹厚度,平均光敏感度,以及FFA示渗漏点渗漏情况为观察指标。结果治疗前两组各指标差异无显著性意义(P>0.05),治疗后1m治疗组各项指标均比对照组显著好转(P<0.05),治疗后6m两组视力提高和Amsler表暗点及变形情况差异无显著性意义(P>0.05),治疗组平均光敏感度高于对照组(P<0.05),黄斑中心凹厚度小于对照组(P<0.05)。随访过程中未发现有严重并发症者。结论TTT治疗“中浆”安全有效,能缩短病程,且能保护黄斑的视功能。
Objective To investigate the therapeutic efficacy of transpupillary thermal therapy （TIT） for central serous chorioretinopathy （CSC）. Methods Therapeutic group Twenty-five eyes of 25 patients whose illness had been diagnosed as CSC by fundus fluorescein angiography （FFA） and optical coher-ence tomography （OCT） were treated with diode 810 laser. According to the focus size, the diameters of beam spot varied from 0.5, 0.8, 1.2ram; and the power was 100. 120, 150mW correspondingly, with the duration fo 60 seconds. The follow-up examination was performed at 1, 3, 6, 12 months after treat-ment, and the repetitious treatment would be taken if recurrence was found. Best corrected visual acuity, Amsler chart, 30° central visual field, FFA, OCT were examined in the follow-up examination. Control group The patients whose sodium fluorescein test is positive were selected as control group. Twelve eyes of 12 patients whose illness had been diagnosed as CSC by OCT and fundus examination take Rutin and Vitamin C. The follow-up time and examination are the same with the therapeutic group. Results Take χ^2 test and t test to investigate the Amsler chart, best corrected visual acuity, the macular thickness measured by OCT, mean sensitivity and the exudation demonstrated by FFA between the two group. There is no obvious differ-ence in each item between the two group before treatment （P〉0.05）, but every item of therapeutic group is better than that of control group at 1 month after treatment. There is no obvious difference in Amsler chart and best corrected visual acuity between the two group at 6 months after treatment （P 〉0.05）. The mean sensitivity of therapeutic group is better than that of control group and the macular thickness is thinner than that of control group （ P 〈 0.05 ）. One patient in therapeutic group recurred during follow up and FFA showed the exudation spot is different from the first occurrence. There is no serious complication during follow-up. Conclusions TTT is safe and effective for CSC. It can shorten the coursing of CSC and protect the macular visual function. The mechanism probably have something with that light theraml effect can make the RPE remove to enclcse the exudation spot. Whether TTT can reduce the recurrence rate still need large sample, long-term follow-up.
出处
《中国实用眼科杂志》
CSCD
北大核心
2005年第10期1034-1037,共4页
Chinese Journal of Practical Ophthalmology
