激光治疗中浆的临床观察及视力同渗漏位置的相关性研究

Clinical observation of laser treatment for central serous chorioretinopathy choroidal diseases and study on relationship between visual acuity with leakage location

摘要:

目的：分析低能量视网膜激光光凝术治疗中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy，CSC)的临床效果以及视力同渗漏位置的相关性。

方法：采用低能量激光治疗渗漏点在黄斑旁中心凹外的53例中浆患者行激光封闭为治疗组。常规药物治疗的33例为对照组。对比观察两组患者治疗前后自觉症状、眼底、眼底荧光血管造影(fundus fluorescein angiography，FFA)的改变，眼底光学相干断层扫描(optical coherence tomography，OCT)检查，视力提高程度，以及治愈率、复发率。对全部126例患者的视力同渗漏位置进行相关性分析。

结果：治愈率比较：治疗组术后4wk治愈率为92.5%，对照组在用药后4wk治愈率为30.3%。两组相比，有显著性差异(P<0.01)，治疗组和对照组在治疗后2，4wk； 3，6mo均存在显著性差异(P<0.01)。对照组复发率为12.1%，治疗组复发率为11.3%。两组相比，无显著差异性(P>0.05)。非参数相关分析法对视力与荧光渗漏点位置之间的关系进行比较，其相关系数r=0.216，P=0.0001，两者存在着线性正相关关系。

结论：低能量激光对渗漏点在黄斑旁中心凹外的患者早期进行激光治疗，可以缩短病程，提高视力和临床治愈率，提高视觉质量，但不能降低复发率。视力与渗漏位置呈正相关性，对判断预后及治疗有临床指导作用。

Abstract:

AIM:To analyze the low energy laser photocoagulation under treatment of central serous chorioretinopathy(CSC)correlation of clinical effect and visual acuity with leakage location.

METHODS:Using low energy laser on the leakage point in the parafoveal and 53 cases of central serous chorioretinopathy patients underwent laser closed, drug treatment group and 33 cases as control. Comparison of two groups was observed before and after treatment in patients with symptoms, ocular fundus, fundus fluorescein angiography(FFA)changes, fundus optical coherence tomography technology(OCT)examination, visual acuity improved in degree, and the relationship between the cure rate, relapse rate. All 126 cases were associated with visual leakage location analysis.

RESULTS:The cure rate of lasercomparison: 4 weeks after operation, the cure rate was 92.5%. The drug therapy group at 4 weeks after treatment cure rate was 30.3%.The two groups were compared(P<0.01), and there was significant difference. The laser group and treatment group after treatment in 2 weeks, 4 weeks, in March June, and there was significant difference(P<0.01). The medicine group the recurrence rate was 12.1%, the lasertreatment group and recurrence rate was 11.3%. The two groups were compared, no significant difference(P>0.05). Nonparametriccorrelation analysis method to compare the relationship between visual acuity and fluorescence leakage point location, the correlation coefficient(r=0.216, P=0.0001), there is a positive linear correlation between.

CONCLUSION:The leakage point in the parafoveal outside in early stagelaser in the treatment of low energy laser, can shorten the course of disease, improve the cure rate of visual acuity and clinical, and improve the visual quality, but can not reduce the recurrence rate. There is a positive correlation between visual acuity and leakage location, clinicalguidance for prognosis and treatment.