摘要
目的评估微视野检测在中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy, CSC)疗效评价中的应用价值。方法 2015年1月至2017年10月,经眼底彩照、频域光学相干断层扫描检查(spectrum-domain optical coherence tomography,SD-OCT)及眼底荧光血管造影(fundus fluorescein angiography, FFA)检查确诊且接受治疗的CSC患者92例92只眼,分为两组:微脉冲治疗组(A组)患者62例;半剂量PDT治疗组(B组)患者30例,接受半剂量PDT治疗,两组患者术前和术后1个月均行最佳矫正视力(best-corrected visual acuity, BCVA)、微视野检查。同时选取年龄相匹配健康者30例正常健康眼作为对照组(C组),不进行激光治疗,仅接受微视野检查。评估治疗后CSC患者视力、黄斑区光敏感度及固视稳定性改变。所有患者在治疗前后均接受了最佳矫正视力和微视野检查。结果治疗后1个月,A和B组92例CSC患者BCVA由术前的(0.56±0. 2),提高到(0.80±0.2)(P <0.05),但治疗后视力改善仍低于正常健康者(0.98±0.1)。黄斑区光敏感度治疗前为(19.2±8.7)dB,显著低于正常健康眼的(29.7±1.2)dB(P<0.001)。治疗后提高到(25.1±11.9)dB,与治疗前比较差异具有统计学意义(P <0.05),但仍低于正常对照组的黄斑区平均光敏感度(P <0. 05)。92例CSC患者治疗前固视稳定为47只眼(51.1%),相对不稳定为24只眼(26.1%),不稳定为21只眼(22. 8%),治疗后稳定67只眼(72. 8%),相对不稳定17只眼(18.5%),不稳定8只眼(8.7%),治疗后与治疗前比较,差异具有统计学意义(P <0. 05)。结论微视野检测可以显示CSC患者治疗前后黄斑区光敏度和固视稳定性的改变,为更全面的了解治疗效果提供重要信息。
Objective To evaluate the value of microperimetry for the treatment of central serous chorioretinopathy( CSC).Methods Nighty-two patients(92 eyes) diagnosed as CSC with fundus photography, spectrum-domain optical coherence tomography(SD-OCT) and fundus fluorescein angiography(FFA) from Jan. 2015 to Oct. 2017 were enrolled in the study, treated and compared with healthy eyes(30 eyes). Best-corrected visual acuity(BCVA) and MAIA microperimetry were performed before the treatment and1 month after the treatment. The BCVA, macular sensitivity and macular fixation were evaluated.Results One month after the treatment,the mean BCVA was improved from(0. 56 ±0. 2) to(0. 80 ±0. 2)(P <0. 05). The mean macular sensitivity was( 19. 2 ± 8. 7) dB before the treatment in CSC group,much lower than(29. 7 ± 1. 2) dB of healthy control group(P <0. 05),and improved to(25. 1 ± 11. 9) dB after the treatment(P<0. 05). The results of fixation stability examination revealed that 47 eyes(51. 1%) had stable fixation, 24 eyes(26. 1%) relative unstable fixation and 21 eyes(22. 8%) unstable fixation before the treatment. After the treatment, 67 eyes(72. 8%) had stable fixation, 17 eyes(18. 5%) relative unstable fixation and 8 eyes(8.7%) unstable fixation, indicating a difference that is statistically significant(P <0.05).Conclusions Microperimetry can show the changes of the macular sensitivity and fixation and is hence able to evaluate the effect on the treatment for CSC.
作者
周立军
赖坤贝
黄创新
许发宝
巩亚军
钟小菁
吕林
金陈进
ZHOU Li-jun;LAI Kun-bei;HUANG Chuang-xin;XU Fa-bao;GONG Ya-jun;ZHONG Xiao-jing;LV Lin;JIN Chen-jin(State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangzhou 510060,China)
出处
《中国激光医学杂志》
CAS
2018年第6期365-369,共5页
Chinese Journal of Laser Medicine & Surgery
基金
广东省科技厅基金(2014A020212527)
中山大学中山眼科中心临床研究专项基金(PT3031101038)
