532、577和810 nm微脉冲激光治疗慢性中枢性浆液性脉络膜视网膜病变：系统回顾和荟萃分析

IF 1.8 4区医学 Q2 OPHTHALMOLOGY

International journal of ophthalmology Pub Date : 2025-10-18 eCollection Date: 2025-01-01 DOI:10.18240/ijo.2025.10.23

Raphaela M Fuganti, Danielle M Cadide, Maikon V Fuganti, Dillan Cunha Amaral, Ricardo Noguera Louzada, Antonio M Casella

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引用次数: 0

摘要

目的：评价532、577和810 nm激光作为非溶解性中心性浆液性脉络膜视网膜病变（CSC）初始治疗的有效性。方法：根据Cochrane协作手册和系统评价和荟萃分析（PRISMA）指南的首选报告项目，纳入随机临床试验（rct），非随机队列，观察性研究和病例系列（bbb10例），评估这些激光治疗非溶解性CSC，随访时间≥3个月。非分辨性CSC定义为持续视网膜下积液（SRF），持续时间为3 ~ 6个月。检索在PubMed， Cochrane图书馆和Embase（2025年1月17日）进行。两位作者独立进行数据提取并评估偏倚风险。主要结果是3-6个月时光学相干断层扫描（OCT）的SRF分辨率。视网膜中央厚度（CRT）和最佳矫正视力（BCVA）是次要结果。采用随机效应模型计算95%置信区间（ci）的合并比例，并采用I2和Q统计量评估异质性。结果：纳入24项研究（3项随机对照试验，21项非随机对照试验），涉及829只非分辨性CSC眼（77.6%为男性，平均年龄45.36岁）。SRF分辨率为59% (95%CI: 0.51-0.67; I2 =72.6%)，两种激光器间无显著差异。微调填充调整将SRF分辨率提高到65% （95%CI: 0.44-0.81）。CRT显着下降了126.32µm (95%CI: 95.99-156.65; PI2 =95.7%)，其中810 nm激光器的下降幅度最大。BCVA变化为0.10 logMAR (95%CI: -0.03 ~ 0.22； P=0.13; I2 =96.6%)，表明视力无明显改善。结论：本荟萃分析支持使用532、577和810 nm亚阈值微脉冲激光在非分辨性CSC中解决SRF同样有效。

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Micropulse laser therapy at 532, 577, and 810 nm for chronic central serous chorioretinopathy: a systematic review and Meta-analysis.

Aim: To evaluate the effectiveness of 532, 577, and 810 nm lasers as an initial treatment for non-resolving central serous chorioretinopathy (CSC).

Methods: Following the Cochrane Collaboration Handbook and Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, randomized clinical trials (RCTs), non-randomized cohorts, observational studies, and case series (>10 cases) assessing these lasers for non-resolving CSC with ≥3mo of follow-up were included. Non-resolving CSC was defined as persistent subretinal fluid (SRF) for >3-6mo. Searches were conducted in PubMed, the Cochrane Library, and Embase (January 17, 2025). Two authors independently performed data extraction and assessed the risk of bias. The primary outcome was SRF resolution on optic cherence tomography (OCT) at 3-6mo. Central retinal thickness (CRT) and best-corrected visual acuity (BCVA) were secondary outcomes. A random-effects model was employed to calculate pooled proportions with 95% confidence intervals (CIs), and heterogeneity was assessed using I² and Q statistics.

Results: Twenty-four studies (3 RCTs, 21 non-RCTs) involving 829 non-resolving CSC eyes (77.6% male, mean age 45.36y) were included. SRF resolution was 59% (95%CI: 0.51-0.67; I² =72.6%), showing no significant difference between lasers. Trim-and-fill adjustment raised SRF resolution to 65% (95%CI: 0.44-0.81). CRT significantly decreased by 126.32 µm (95%CI: 95.99-156.65; P<0.0001; I² =95.7%), with the largest reduction noted for the 810 nm laser. BCVA change was 0.10 logMAR (95%CI: -0.03 to 0.22; P=0.13; I² =96.6%), indicating no significant visual improvement.

Conclusion: This Meta-analysis supports the use of 532, 577, and 810 nm subthreshold micropulse lasers as equally effective in resolving SRF in non-resolving CSC.

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来源期刊

International journal of ophthalmology Medicine-Ophthalmology

CiteScore

2.50

自引率

7.10%

发文量

3141

审稿时长

4-8 weeks

期刊介绍： · International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online). This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed, PubMed-Central, Chemical Abstracts, Scopus, EMBASE , and DOAJ. IJO JCR IF in 2017 is 1.166. IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication. General Scientific Advisors include Prof. Hugh Taylor (President of ICO); Prof.Bruce Spivey (Immediate Past President of ICO); Prof.Mark Tso (Ex-Vice President of ICO) and Prof.Daiming Fan (Academician and Vice President, Chinese Academy of Engineering. International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of AAO/PAAO) et al. Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society). Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press). Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics). Associate Editors-in-Chief include: Prof. Ning-Li Wang (President Elect of APAO); Prof. Ke Yao (President of Chinese Ophthalmological Society) ; Prof.William Smiddy (Bascom Palmer Eye instituteUSA) ; Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA); Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society); Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA); Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA). IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles, both basic and clinical papers. Instruction is Welcome Contribution is Welcome Citation is Welcome Cooperation organization International Council of Ophthalmology(ICO), PubMed, PMC, American Academy of Ophthalmology, Asia-Pacific, Thomson Reuters, The Charlesworth Group, Crossref,Scopus,Publons, DOAJ etc.