摘要
Abstract
Laser-induced macular injury represents an increasingly prominent public health concern in the field of ophthalmology,with its mechanisms involving photochemical,photothermal,and photomechanical effects.Clinically,it primarily manifests as decreased visual acuity,central scotoma,and blurred vision.Adults typically seek medical attention promptly,whereas children often delay treatment due to concealment of symptoms.Fundus examination reveals non-specific alterations in the retinal pigment epithelium(RPE)layer,along with yellow or gray lesions in the macular region.In severe cases,full-thickness retinal breaks,preretinal hemorrhage,or choroidal neovascularization(CNV)may be observed.Among auxiliary diagnostic techniques,optical coherence tomography(OCT)precisely localizes the layers of injury,displaying a dense hyperreflective outer band in the acute phase and photoreceptor regeneration or scarring in the chronic phase.Fluorescein fundus angiography(FFA)combined with indocyanine green angiography(ICGA)evaluates vascular leakage and CNV.Optical coherence tomography angiography(OCTA)provides non-invasive three-dimensional vascular diagnosis,while fundus autofluorescence(FAF)quantifies the extent of injury.Electroretinography(ERG)detects cone cell dysfunction,and adaptive optics scanning laser ophthalmoscopy(AO-SLO)along with near-infrared reflectance(NIR)imaging reveal morphological changes in photoreceptors.Multimodal imaging combining OCT with other auxiliary examinations enhances diagnostic accuracy.There is no consensus on treatment strategies;conservative pharmacological approaches include corticosteroids to suppress inflammation,lutein for antioxidant protection,and local triamcinolone acetonide injections to reduce edema.Surgical interventions target full-thickness retinal breaks(vitrectomy combined with internal limiting membrane peeling),sub-internal limiting membrane and sub-hyaloid hemorrhages in the macular region(YAG laser capsulotomy),and secondary CNV(intravitreal anti-vascular endothelial growth factor injections).However,controversies persist regarding injections).However,controversies persist regarding injections).However,controversies persist regarding the timing of administration,dosage,and long-term efficacy of treatment regimens,necessitating validation through large-scale clinical studies.Prevention and control require a multifaceted approach:strengthening public education and enforcing stringent market regulations to curb the circulation of high-risk laser products,as well as promoting multicenter research to optimize treatment windows and protocols.This article reviews the advancements in basic theoretical research on the epidemiological characteristics,clinical manifestations,diagnosis,and treatment of laser-induced macular injury,aiming to provide references for its prevention,diagnosis,and treatment.关键词
激光/黄斑损伤/多模态影像/治疗应用Key words
laser/macular injury/multimodal imaging/therapeutic applications分类
医药卫生
