中心性浆液性脉络膜视网膜病变激光治疗对中心视野的影响

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目的 :分析中心性浆液性脉络膜视网膜病变 (central serous chorioretinopathy,CSC)自愈与激光治疗后中心视野 (central visualfield,CVF)的变化对比观察。方法 :连续就诊的 34例 38眼经眼底荧光血管造影 (fundus fluorescien angiography,FFA)确认的 CSC病人 ,单眼 30例 ,双眼 4例 ,其中 2 6眼呈“炊烟状”或“墨渍样”改变 ,作为激光治疗组 ;12眼呈“玻璃疣状”改变 ,不予激光治疗 ,作为自愈组给予维生素口服。治疗前及痊愈后均行 CVF检查。结果 :激光组 2 6眼治疗后平均 33.88± 11.71天视力恢复。其中发作次数少的 2 2眼 CVF完全恢复正常占 84.6 2 %。另 4眼复发次数较多 ,CVF异常 ,占 15 .38%。自愈组 12眼 ,平均 12 6 .6 7± 38.2 2天视力恢复 ,首次发作的 6眼 CVF恢复正常占 5 0 %。两组病程及视敏度相比 ,P<0 .0 5 ,有统计学意义。两组按复发次数多少分开比较 ,虽然激光组平均缺损 (mean defect,MD)、缺失偏离 (lossvariance,L V)比自愈组要好 ,但无统计学意义。结论 :CSC愈后 CVF异常与其反复发作呈正相关 ,而恰当的激光治疗不会造成 CVF的损伤 Objective: To compare the changes of central visual field (CVF) after central serous chorioretinopathy (CSC) self-healing and laser treatment. Methods: Thirty-four eyes of 34 CSC patients confirmed by fundus fluorescein angiography (FFA) were enrolled in this study. Thirty eyes were monocular and 4 eyes. Among them, 26 eyes were changed to “smoke-like” or “ink stain” , As a laser treatment group; 12 eyes were “verrucae” change, no laser treatment, as a self-healing group given vitamin oral. CVF examination was performed before treatment and after recovery. Results: In the laser group, the average visual acuity of the eyes was 33.88 ± 11.71 days after treatment in 26 eyes. Among them, 22 eyes with less episodes of CVF completely returned to normal with 84.6 2%. The other 4 eyes had more recurrences and CVF was abnormal, accounting for 15.38%. In 12 eyes of self-healing group, the mean visual acuity was 12.66 ± 38.2 days, and the first 6 eyes recovered 50% of normal CVF. Two groups of disease duration and visual acuity, P <0. 05, with statistical significance. The two groups were compared separately according to the number of recurrence. Although the mean defect (MD) and loss variance (L V) of the laser group were better than those of the self-healing group, they were not statistically significant. CONCLUSIONS: The abnormality of CVF after CSC is positively correlated with its recurrence, while proper laser treatment will not cause CVF damage
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