摘要
目的观察以532nm绿激光眼底光凝治疗为主,辅以营养神经中西药物治疗中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的治疗效果。方法2000年1月～2005年12月末在我院眼科门诊及住院治疗,采用532nm绿激光眼底光凝治疗为主的综合治疗CSC204例(209眼)为激光组,仅采用药物治疗的CSC47例(48眼)为对照组;治疗后观察眼底情况和视力变化。随访时间≥3月。结果激光组治疗后1月和3月时临床治愈分别为172眼(81.3%)和198眼(94.7%);对照组治疗1月和3月时临床治愈分别为12眼(25%)和30眼(62.5%)。激光组在治疗后1个月(χ2=63.01,P<0.001)和3个月时(χ2=40.52,P<0.001)的疗效明显优于对照组。激光组治疗后1月和3月时平均视力分别为0.9±0.33和0.97±0.13,均较治疗前平均视力0.57±0.3有明显提高(u=10.7,P<0.01和u=16.3,P<0.01);对照组治疗1月和3月时平均视力分别为0.70±0.28和0.82±0.23,也均较治疗前平均视力0.55±0.32有明显提高(u=2.44,P<0.05和u=4.75,P<0.01),但治疗后1月和3月时激光组的平均视力明显高于对照组(u=4.31,P<0.01和u=4.36,P<0.01)。激光组眼底光凝治疗后2周时155眼黄斑区水肿消退(74.1%),治疗后4周时192眼黄斑区水肿消退(91.9%);7眼进行了补充光凝;随访3～18个月,眼底检查未提示复发。对照组在治疗后6～9月复发10例(20.8%)。结论眼底激光光凝术治疗CSC操作简便且疗效确切,少有复发,疗效明显优于单纯药物治疗组。波长为532nm的绿激光在屈光间质透过率高,易被视网膜色素上皮吸收,而被黄斑部叶黄素吸收少,在眼内和视网膜内散射更低,所以该波长激光也常被用来治疗视网膜裂孔,较其他波长的眼底激光治疗器更为高效、安全。
Objective To observe the effect of 532nm green laser photoeoagulation on central serous chorioretinopathy assisted by medicine and chinese traditional drugs. Methods 204 cases （209 eyes） were treated by 532nm green laser photocoagulation （laser group）, and 47 cases （48 eyes） were treated by medicine and Chinese traditional drugs （drug group）,the patients treated in our hospital from Jan,2000 to the end of Dec,2005.The patients＇ fundus and visual acuities were observed and the following-up was made in more than 3 months. Results 172 eyes （81.3%） were recovered after 1 month and 198 eyes（94.7%） after 3 months of the photoeoagulation in laser group; while in drug group, 12 eyes （25%） were recovered after hnonth treated by drugs and 30 eyes （62.5%） after 3 months. The effects in laser group was better than that of drug group after 1 month （ x^2= 63.01 ,P〈0.001 ） and after 3 months （AA=40.52,P〈0.001） of treatment, visual acuities were 0.9±0.33 after 1 month of photoeoagulation and 0.97±0.13 after 3 months; these visual acuities, in laser group were better than that in the visual aeuities, 0.57±0.3 before photocoagulation （u=10.7,P〈0.01 and u=16.3,P〈0.01）; and visual acuities were 0.70±0.28 after 1 month treated by medicine and 0.82±0.23 after 3 months; these visual acuities in drug group were better than that of 0.55±0.32 before treatment （u=2.44,P〈0.05 和 u=4.75 ,P〈0.01）. The visual acuities of laser group were better than that of drug group after 1 month and after 3 months by treated （u=4.31 ,P〈0.01 and v=4.36,P〈0.01）. The macular edema of 155 eyes （74.1%） had disappeared after 2 weeks by photocoagulation; and 4 weeks later, 192 eyes （91.9%） disappeared; 7 eyes experienced twiee photoeoaeulation; These cases did not recurred by fundus exam in the follow-up of 3-18 months. After treatment at 6-9 months, 10 eyes （20.8%） recurred in drug group. Conclusion Treating CSC is quite simply and more available and rare recurring with the photoeoaeulation than drugs. 532nin green laser is more available and safely in treating CSC than other laser, because it is easier to pass ocular media, and being absorbed much better by retinal pigment epithelium and barely absorbed into xanthophylls.
出处
《中国现代医药杂志》
2007年第12期10-12,共3页
Modern Medicine Journal of China
