目的：探讨577nm阈值下微脉冲激光(SML)治疗慢性中心性浆液性脉络膜视网膜病变(CSC)的有效性及安全性。

方法：采用前瞻性单臂病例研究，对慢性CSC患者24例32眼行577nm SML治疗。治疗后共计随访6mo，每月行最佳矫正视力(BCVA，LogMAR)及光学相干断层扫描(OCT)检查。于治疗后1、3、6mo行眼底荧光血管造影(FFA)。

结果：基线期，32眼的BCVA为0.46±0.34，中心视网膜厚度(CRT)为259.15±57.54μm。SML治疗后1mo，21眼(66%)已无视网膜下液，11眼(34%)的视网膜下液仍存在，BCVA为0.43±0.27，CRT为232.13±42.58μm，CRT较基线期显著降低(P<0.05)。SML治疗后3mo，5眼(16%)仍有视网膜下液，存在视网膜色素上皮(RPE)荧光素渗漏； 患眼BCVA为0.39±0.26，CRT为231.26±49.25μm，CRT较基线期仍显著降低(P<0.05)。对FFA显示RPE仍有荧光素渗漏的5眼再次行SML。治疗后6mo，仅见3眼(9%)的视网膜下液仍存在； 患眼BCVA为0.19±0.47，CRT为217.25±35.54μm，BCVA及CRT均较基线期有显著改善(P<0.05)。

结论：SML对于慢性CSC的治疗有效且安全，有望成为慢性CSC的治疗选择。

METHODS: Prospective single-arm case study. There were 24 patients(32 eyes)with chronic CSC treated by using 577nm SML. A total of 6mo was followed up after treatment, the best corrected visual acuity(BCVA, LogMAR)and optic coherence tomography(OCT)were performed at each month. Fluorescein fundus angiography(FFA)was performed at 1,3 and 6mo after treatment.

RESULTS: The BCVA was 0.46±0.34 and central retinal thickness(CRT)was 259.15±57.54μm of 32 eyes at baseline period. After treatment of SML at 1mo, there was no subretinal fluid in 21 eyes(66%), and subretinal fluid was observed in 11 eyes(34%). The BCVA was 0.43±0.27, the CRT was 232.13±42.58μm. CRT was significantly reduced compared to the baseline period(P<0.05). After treatment of SML at 3mo, subretinal fluid and fluorescein leakage from retinal pigment epithelium(RPE)were observed in 5 eyes(16%). The BCVA was 0.39±0.26 and CRT was 231.26±49.25μm. The CRT was still significantly lower than baseline period(P<0.05). The 5 eyes with subretinal fluid and leaked fluorescein were treated by using SML again. After treatment at 6mo, subretinal fluid was observed in only 3 eyes(9%). The BCVA was 0.19±0.47 and CRT was 217.25±35.54μm. Both of the BCVA and CRT showed a significant improvement from the baseline period(P<0.05).

CONCLUSION:SML seems effective and safe for treatment of chronic CSC. It may be an alternative way for treatment of chronic CSC.