Micro-pulse laser therapy for acute central serous chorioretinopathy / 中华眼底病杂志

ABSTRACT

Objective To observe the effect of micro-pulse laser in the treatment of acute central serous chorioretinopathy (CSC).Methods 105 cases (114 eyes) with clinically diagnosed acute CSC were included in the study,including 78 males (86 eyes) and 27 females (28 eyes) with an average age of (40.40±7.80) years,and mean duration of 26 days.All patients were examined for best corrected visual acuity (BCVA),slit lamp microscope and pre-lens,direct ophthalmoscopy,color fundus photography,fluorescein angiography combined with indocyanine green angiography (ICGA),and micro-perimetry.Patients were randomly divided into micro-pulse laser treatment group (treatment group,61 eyes) and control group (51 eyes).The age (Z ＝-0.374),gender ratio (x2=0.010),disease duration (Z=-0.525),BCVA (t=1.885),foveal thickness (CFT) (t=-1.754) and macular light sensitivity (t=1.255) were similar between the two groups.The micro-pluse laser treatment was performed with an 810 nm infrared diode laser at the active leakage site on retinal pigment epithelium guided by ICGA.The exposure time was 0.2 s,effective working time was 15％,the laser spot diameter was 100 μm,and the distance between 2 spots was 100 μm.The control group received pseudo-treatment using the same laser parameters.After 2 weeks,1month,3 months and 6 months of treatment,all patients were examined with BCVA,ocular fundus,optical coherence tomography and micro-perimetry.These parameters were compared between the 2 groups.Results The subretinal fluid of 39 eyes in the micro-pulse laser group and that of 3 eyes in the control group were absorbed completely.The cure rates in the micro-pulse laser group (61.9％) was higher than that in the control group (x2 =38.015,P＜0.01).In the micro-pulse laser group,the mean BCVA was 67.81±11.70 at baseline,which increased significantly to 75±9.91,76.78± 9.43,78.56 ± 8.57 and 78.52 ± 8.60 at 2 weeks,1 month,3 months and 6 months after treatment respectively.In the control group,that was 63.86±10.35,64.20±11.43,63.90±10.88,64.55±11.04,64.10±11.12 at baseline,2 weeks,1 month,3 months,6 months post-treatment respectively.The mean post treatment BCVA at each time point were significantly higher in the micro-pulse laser group than that in the control group (P＜ 0.01).The mean CFT was (380.94 ± 50.73) μm at baseline,which reduced to (268.44±44.20),(242.78±41.31),(235.46±38.44),(235.56±38.71) μm at 2 weeks,1 month,3 months and 6 months post-treatment respectively in the nmicro-pulse laser group.In the control group,that was (397.98±52.61),(334.55±59.15),(316.16±55.25),(314.47±53.27),(321.51±55.74) μm at baseline,2 weeks,1 month,3 months,6 months post-treatment respectively.The mean post-treatment CFT at each time point in the micro-pulse laser group were decreased significantly compared to that in the control group (P＜0.01).The mean central retinal sensitivity was (15.03 ± 2.00) dB at baseline,which enhanced to (17.06 ± 1.71),(17.37 ± 1.61),(17.56 ± 1.58),(17.48 ± 1.53) dB at 2 weeks,1 month,3 months and 6 months post-treatment respectively in the micro-pulse laser group.In the control group,that was (14.54±2.22),(14.80±2.16),(14.88±2.09),(14.82±2.07),(14.69±2.11) dB at baseline,2 weeks,1 month,3 months and 6 months post-treatment respectively.The mean central retinal sensitivity at each time point of post-treatment in the micro-pulse laser group were enhanced significantly compared to that in the controlled group(P＜0.01).Conclusion In the treatment of acute CSC,micro-pulse laser can improve BCVA,reduce the mean CFT and improve the mean central retinal sensitivity.It is an effective and safe method to treat acute CSC.