ObjectiveTo observe the effect of micro-pulse laser in the treatment of acute central serous chorioretinopathy (CSC). Methods105 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 (χ2=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. ResultsThe 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 (χ2=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 micro-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). ConclusionIn 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.
ObjectiveTo investigate the correlation of visual sensitivity, best corrected visual acuity (BCVA) and central retinal thickness (CRT) in diabetic macular edema (DME).MethodsA retrospectives study. Forty-five eyes of 30 patients in DME were included. There were 20 eyes of 16 males, 25 eyes of 14 females, with an average age of 54.49±7.45 years. All the patients had type 2 diabetes; the average duration of diabetes was over 10 years. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logarithmic logarithm (logMAR) visual acuity. The following parameters provided by the MAIA microperimetric device were evaluated, including average threshold (AT), macular integrity index (MI), fixation indexes (P1 and P2), bivariate contour ellipse area (BCEA) for 63% and 95% of points, and horizontal and vertical axes of the ellipse of fixation (H63, H95, V63, V95). The CRT was measured and the integrity of the ellipsoidal band was observed by optical coherence tomography (OCT). The integrity of the ellipsoid band was divided into continuous smooth (group A): fully visible; part of the light band was interrupted (B group): not completely visible; missing light band (C group): completely invisible. Pearson correlation analysis was used to analyze the correlation between the factors; non-parametric tests were used to compare the logMAR BCVA, AT, and CRT between the different ellipsoid zone integrity groups; multiple linear regression analysis was used to analyze factors related to AT.ResultsPearson correlation analysis showed that the logMAR BCVA was positively correlated with MI (r=0.303, P=0.04) and CRT (r=0.342, P=0.02), negatively correlated with AT (r=−0.59, P=0.00) and P1 (r=−0.38, P=0.01). There was negative correlation between AT and MI (r=−0.55, P=0.00). The result of multivariate linear regression analysis showed that the logMAR BCVA is inversely correlated with AT (t=−3.53, P=0.001). Group A, B and C were 23, 17 and 5 eyes in the 45 eyes, respectively. There were significant differences in logMAR BCVA, AT, and CRT between the three groups of eyes (P=0.045, 0.049, 0.018).ConclusionsIn DME patients, the logMAR BCVA was positively correlated with CRT, negatively correlated with AT and P1. The logMAR BCVA is inversely correlated with AT. Microperimetry combined with OCT and visual acuity can be used to assess the visual function of patients with DME.
ObjectiveTo observe the clinical efficacy of dexamethasone intravitreal implant (DEX) in the treatment of active non-infectious uveitis macular edema (NIU-ME).MethodsA retrospective observational study. From February 2018 to February 2019, 23 patients (26 eyes) were included in the study who were diagnosed with NIU-ME at the Department of Ophthalmology, Central Theater Command General Hospital and received intravitreal DEX treatment. Among 23 patients, there were 8 males (8 eyes) and 15 females (18 eyes); the average age was 46.9 years; the average course of disease was 9.2±2.4 months. All the affected eyes underwent BCVA and intraocular pressure examination; at the same time, OCT was used to measure the central retinal thickness (CMT) of the macula. Snellen visual acuity chart was used for visual inspection. The average BCVA of the affected eye was 0.281±0.191, the average intraocular pressure was 16.2±0.8 mmHg (1 mmHg=0.133 kPa), and the average CMT was 395.4±63.7 μm. Among the 23 patients, 8 patients had middle uveitis and 15 patients had posterior uveitis. Seven patients had received intravenous infusion of methylprednisolone, 5 patients had been treated with methylprednisolone combined with immunosuppressive agents, and 11 patients had not received any treatment. All the affected eyes were treated with DEX intravitreal injection. Patients received repeated visual acuity, intraocular pressure and OCT examination with follow-up after injection. During the follow-up period, patients with recurrence of edema or poor efficacy, systemic methylprednisolone and intravitreal reinjection of DEX, triamcinolone acetonide or methotrexate should be considered based on the patient's own conditions. We observed the changes of BCVA, intraocular pressure and CMT before and after injection in the affected eyes, and analyzed the variance of a single repeated measurement factor. At the same time, we observed the occurrence of ocular adverse reactions and systemic complications.ResultsAfter treatment 1.2±0.4, 3.3±0.3, 6.7±1.1, 9.2±1.1, 12.2±0.6 months, the BCVA of the affected eyes were 0.488±0.296, 0.484±0.266, 0.414± 0.247, 0.411±0.244 and 0.383±0.232; CMT was 280.2±42.7, 271.0±41.4, 292.5±42.9, 276.2±40.5, 268.4±26.6 μm, respectively. Compared with before treatment, the BCVA and CMT of the all eyes increased after treatment, and the difference was statistically significant (F=30.99, 5 196.92; P＜0.000). Among 23 eyes completed a 12-month follow-up, 13 eyes (56.5%) received 2 injections, 3 eyes (13.0%) received 3 injections, and other 7 eyes (30.4%) received only 1 injection. After treatment 1.2±0.4 months, 5 patients (6 eyes) with intraocular pressure＞25 mmHg gradually returned to normal after treatment with two eye drops for lowering intraocular pressure; 1 patient (2 eyes) with intraocular pressure＞40 mmHg, the intraocular pressure gradually returned to normal after 3 kinds of eye drops for lowering intraocular pressure.ConclusionIntravitreal injection of DEX in the treatment of NIU-ME can improve the visual acuity of the affected eye and reduce CMT.
Objective To investigate the clinical characteristics of patients with polypoidal choroidal vasculopathy (PCV) from Central China . Methods This was a retrospective study, and 403 eyes of 362 patients diagnosed as PCV by ocular fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were enrolled. The general clinical data, fundus manifestation and ocular fundus examinations were statistically analyzed. Results Three hundred and sixty-two cases included 249 males (68.8%) and 113 females (31.2%). Age ranged from 45 to 91 years old, and mean age was (64.81plusmn;9.31) years old. Bilateral lesions were observed in 41 patients (11.3%) and unilateral lesions were observed in 321 patients (88.7%)． In these 403 eyes, typical orangered lesions were observed in 162 eyes (40.2%); yellowishwhite exudate could be found in 185 eyes (45.9%); 268 eyes (66.5%) showed variable degrees of subretinal hemorrhage. Drusen was found in 23 eyes (5.7%), pigment proliferation in 20 eyes (5.0%) and fiber vascular scar in 96 eyes (23.8%). The lesions of 386 eyes (95.8%) located in macular region, 53 eyes (13.2%) in peripapillary area. Lesions presented multifoci in 67 eyes (16.6%). Three hundred and four eyes (75.4%) presented typical polypoidal lesions and 152 eyes (37.7%) with abnormal branching choroidal networks. Hemorrhagic retinal pigment epithelial detachments (PED) were found in 200 eyes (49.6%) and serous PED in 96 eyes (23.8%), both existed in 25 eyes（6.2%）. OCT showed 56 eyes (13.9%) presented cystoid dark chamber between the neurosensory retina and 109 eyes (27.0%) with double-layer sign formed by the separation of retinal pigment epithelium and Bruchprime;s membrane (27.0%). Two hundred and seventy-four eyes (68.0%) were found with conelike elevation beneath the RPE layer and 151 eyes (37.6%) with neurosensory detachment. Conclusions In Central China, the majority of PCV patients were male, unilateral. Most PCV lesions were located in the macula. Subretinal hemorrhage, polypoidal lesions and abnormal choroidal vascular networks were common in the PCV patients. Hemorrhagic PED presented a higher ratio than serous PED.
Objective To compare the clinic therapeutic effect of intravitreal ranibizumab injection versus photodynamic therapy (PDT) combined with intravitreal ranibizumab injection for idiopathic choroidal neovascularizatio (ICNV), and to investigate the clinical effect and safety of treatment. Methods A randomized controlled clinical prospective study was performed for 27 patients (27 eyes) diagnosed as ICNV. Fourteen patients were assigned to receive PDT and intravitreal ranibizumab injection (combination roup.n=14); the control group was treated with only intravitreal ranibizumab injection (single group, n=13).The combination group was treated with an intravitreal injection of ranibizumab (0.5 mg/0.05 ml) 1 week after PDT. The bestcorrected visual acuity (BCVA) (logMAR), examination of the ocular fundus, fluorescence fundus angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were performed respectively at 1, 2, 3, 6 and 12 months after treatment. If choroidal neovascularization (CNV) was only partially regressed or the leakage went on during follow-up, those patients were re-injected with ranibizumab. Results After 12 months, the average vision is 0.22plusmn;0.11 in single group, and 0.21plusmn;0.12 in combination group, and the differences were not significant (t=0.187, P=0.853). In single group FFA and ICGA showed completely closed CNV in 10 eyes (77.92%), and almost closed CNV in 3 eyes (23.08%) with obvious reduction of fluorescence leakage. In combination group FFA and ICGA showed completely closed CNV in 12 eyes (85.71%), and almost closed CNV in 2 eyes (14.29%) with obvious reduction of fluorescence leakage; OCT showed the subretinal fluid absorption and reduction of CNV. The average macular retinal thickness (MRT) in single groups is （167.96plusmn;10.69） m, and in combination groups is （171.64plusmn;11.30）m. In single and combination groups MRT decreased significantly at the final follow-up, but no significant differences in both groups (t=-0.887.P=0.389). The average number of intravitreal injection was （1.5plusmn;0.7） in combination group and （2.4plusmn;1.0） in single group (t=2.821，P=0.009). There were no ocular or systemic adverse events observed except for one patient with subconjunctival hemorrhage in the single group.Conclusions Intravitreal ranibizumab injection and PDT combined with intravitreal bevacizumab injection are both effective and safe for the patients with ICNV. The combined therapy can induce CNV regression, fundus hemorrhage and exudation absorption more effectively, and have less recurred CNV and side effects.
Objective To investigate the triggering mechanisms of retinal ganglion cells (RGCs) alterations in retinally degenerative rats. Methods Retinal dystrophic Royal College of Surgeons (RCS-p+) and control RCS rats (RCS-rdy+-p+) were divided into three groups according to postnatal days, including postnatal 21 days (P21d), P60d and P90d, with six rats in each group. Fluorogold was injected into superior colliculus and lateral geniculate body for retrograde labeling RGCs. Then retinal flat mounts were observed under fluorescence microscope to investigate the morphological and RGC changes in density during retinal degeneration. Living retinal mounts or sections were prepared to investigate the calcium concentration of RGCs using a laser confocal microscope. Results At P90d RGCs of control rats were distributed throughout entire retina and appeared uniform. The soma and processes were apparent and clear. But at P90d RGCs of RCS-p+ rats were distributed sparsely in retina. The soma seemed messy and the number and dendritic fields decreased greatly, and some baculiform or broken cells appeared. RGC density was 5 421.0plusmn;72.1/mm2 at P21d, 4 195.0plusmn;136.4/mm2 at P60d and 2 906.0plusmn;133.2/mm2 at P90d. At P21d there were no obvious differences in RGCs density between RCS-p+ and control rats (t=-1.301, P＞0.05). At P60d and P90d there were significant differences in RGC density (t=16.172, 30.131; P＜0.01). At P21d there was no significant differences in RGC intracellular calcium fluorescence intensity between RCSp+ and control rats (t=-1.545, P＞0.05). At P60d and P90d the intracellular calcium fluorescence intensity decreased obviously and the differences were significant (t=-18.058,-15.015; P＜0.01). Conclusions RGCs were secondarily impaired following the loss of photoreceptors at late stages of retinal degeneration, and the morphological and cell density of RGCs were affected. The overloading of intracellular calcium concentration may be the triggering factor of degeneration and death of RGCs in retinally dystrophic rats.
ObjectiveTo compare the visual outcomes of treatment with intravitreal ranibizumab alone or in combination with photodynamic therapy (PDT) in patients with polypoidal choroidal vasculopathy (PCV). MethodsIn this retrospective and comparative study, 36 eyes of 36 patients with PCV were enrolled. Eighteen eyes received 0.5 mg (0.05 ml) ranibizumab injection only (simple injection group) and the other 18 eyes underwent combination therapy of ranibizumab injection and PDT (combination treatment group). Intravitreal ranibizumab was given at the third day after PDT. Re-treatment was considered in clinic examination. The minimum re-treatment interval was 3 months for combination therapy and 1 month for ranibizumab. Best corrected visual acuity (BCVA) of logarithm of the minimum angle of resolution (logMAR) at baseline and each follow-up visit at 1, 3, 6, 12 month was measured as a primary outcome, and complications also observed in every follow-up. ResultsNo complications occurred in these 36 patients during the treatment or follow-up, such as retinal detachment, sustained high intraocular pressure, retinal holes, intraocular inflammation, and systemic adverse reactions. The average times of ranibizumab injections of simple injection group and combined treatment group were (3.00±0.84) and (1.89±0.68) times respective, and the difference was significant (t=4.370, P=0.000). The logMAR BCVA of the first and third month after initial treatment between two groups were significant different (t=0.668, 0.940; P>0.05). However, there was no significant difference between them at the 6th and 12th month (t=2.188, 2.547; P<0.05). In the last follow-up, the logMAR BCVA were improved in simple injection group and combination treatment group compared to the pre-treatment values (t=3.351, 9.408; P=0.012, 0.000). In simple injection group, visual acuity was improved in 3 eyes (16.7%), stable in 13 eyes (72.2%) and decreased in 2 eyes (11.1%). In combination treatment group, visual acuity was improved in 4 eyes (22.2%), stable in 13 eyes (72.2%) and decreased in 1 eyes (5.6%). ConclusionsIntravitreal ranibizumab injection and combined with PDT are both effective to improve vision in patients with PCV. Visual acuity was the same between the two treatments in 3 months after initial treatment; however 6 to 12 months after first treatment, patients received PDT combined with intravitreal ranibizumab injection had better visual acuity than those received the intravitreal ranibizumab injection only.
ObjectiveTo evaluate the efficacy of intravitreal injections of conbercept in choroidal neovascularization (CNV) secondary to pathologic myopia (PM). MethodsA retrospective case series of 37 eyes of 37 patients affected with CNV secondary to PM treated by intravitreal injections of Conbercept. All the patients were examined with best-corrected visual acuity (BCVA) of Early Treatment Diabetic Retinopathy Study (ETDRS) chart, central macular thickness (CMT) of optical coherence tomography (OCT)at baseline. The initial average letters of ETDRS BCVA was 49.86±8.87, CMT was (306.38±31.01) μm. All eyes were treated with intravitreal Conbercept 0.05 ml (10 mg/ml). Follow-up visits were performed monthly after injection. The mean follow-up time was 16.8 months. Injections were repeated according to the situation of BCVA, CMT, subretinal fluid and CNV leakage in follow-up. All eyes received an average of 4.8 injections. BCVA, CMT and ophthalmoscope examination were assessed monthly. The relationship of BCVA improvement and CMT reduction with the data at baseline and number of treatments were analyzed by Spearman Rho correlation respectively. ResultsDuring the 1, 3, 6 and 12 months after treatment, the mean BCVA were all improved with statistically significant difference (t=17.629, P < 0.01).At 12 months, 15 eyes (45.9%) had improvement of 15 letters or more, 32 eyes (86.5%) had improvement of 5 letters or more, and 1 eye (2.7%) had decreased more than 5 letters. During the 1, 3, 6 and 12 months after treatment, the mean CMT were all decreased with statistically significant difference (F=43.726, P < 0.01). At 12 months, the retinal fluid of 34 eyes (91.9%) were absorbed completely; 33 eyes (89.2%) had angiographic closure at that time. There was no significant relevance between BCVA improvement and sex, age and course of the disease (P > 0.05), but a significant negative correlation was found between the BCVA improvement and BCVA at baseline, injection times (P < 0.05). There was no significant relevance between CMT reduction and sex, age, course of the disease and injection times (P > 0.05), but a significant positive correlation was found between CMT reduction and CMT at baseline (P < 0.05). There were no systemic or ocular serious side effects during the follow up. ConclusionsIntravitreal injections of Conbercept showed BCVA improvement and CMT reduction. It appeared to be effective and safe for choroidal neovascularization secondary to pathologic myopia. Intravitreal Conbercept for CNV secondary to PM showed BCVA improvement, CMT reduction and safety.
ObjectiveTo compare the efficacy of photodynamic therapy (PDT) alone or in combined with ranibizumab versus ranibizumab monotherapy (intravitreal injection, IVR) in patients with polypoidal choroidal vasculopathy (PCV). Methods80 eyes of 72 patients with PCV were enrolled into this retrospective and comparative study according to their therapeutic plan. 30 eyes of 28 patients, 28 eyes of 30 patients and 22 eyes of 21 patients were divided into PDT group, ranibizumab 0.5 mg group (IVR group) or the combination group, respectively. The patients with PCV were diagnosed according to clinical symptoms, optical coherence tomography (OCT) and fluorescent indocyanine green angiography (ICGA). The baseline best-corrected visual acuity (BCVA) before treatment was more than 0.05, and there was no retinal fibrosis and scar for all patients. There was no statistical difference of age (F=0.187), gender (χ2=0.423), average BCVA (F=1.120) and central retinal thickness (CRT) (F=0.431) among three groups (P > 0.05). They had not received any treatment before. Patients received verteporfin PDT in PDT group, 3 consecutive monthly IVRs starting day 1 in IVR group, and 3 IVRs after 3 days, 1 month, 2 months of PDT starting day 1 in combination group. Re-treatment was considered 3 months later if the follow up shown no changes in fundus photography, OCT and ICGA. The average follow-up time was 19 months. BCVA at baseline and follow-up visit at 1, 3, 6, 12 months was measured, and the proportion of patients with ICGA-assessed complete regression of polyps at month 6 was recorded as primary outcome. The CRT was measured at baseline and 6 months as secondary outcome. ResultsThere were significant difference of BCVA at 1, 3, 6 and 12 months among three groups(F=5.480, 5.249, 3.222, 4.711; P < 0.05). The average BCVA was significantly better at 1, 3, 6, 12 month than that at baseline(t=-6.632, -4.127, -3.904, -4.494; P < 0.05) in combination group, and was significantly better at 3, 6, 12 months than that at baseline (t=-5.636, -3.039, -3.833; P < 0.05) in IVR group. However there was no significant difference of the average BCVA in PDT group between follow-up at 1, 3, 6, l 2 months and baseline (t=1.973, 0.102, -0.100, -0.761; P > 0.05). The proportion of patients with complete regression of polyps at 6 months was higher in PDT (76.7%) or combination group (68.2%) than IVR group (35.7%) (χ2=0.003, 0.025; P < 0.05). There was no significant difference of CRT among 3 groups at baseline (P=0.651). The mean CRT decreased in all 3 treatment groups over 6 months (t=5.120, 3.635, 5.253; P < 0.05), but there was no significant difference of CRT among 3 groups (F=1.293, P > 0.05). ConclusionsThree therapies could effectively decrease CRT. IVR or IVR combined with PDT are both more effective than PDT therapy to improve vision of PCV patients. PDT or PDT combined with IVR was superior to IVR pnly in achieving complete regression of polyps in 6 months in PCV patients.
ObjectiveTo observe the characteristics of optical coherence tomography (OCT) in central serous chorioretinopathy (CSC) patients with different symptom duration before and after photodynamic therapy (PDT), and investigate its relationship with vision prognosis. Methods93 CSC patients (103 eyes) who had undergone the treatment of PDT were enrolled in this study. The eyes were divided into 3 groups according to symptom duration including group A (< 4 months, 28 eyes), group B (4-6 months, 42 eyes), group C (> 6 months, 33 eyes). The best corrected visual acuity (BCVA) and OCT were performed before and after treatment. Before the treatment, the percentage of patients with regular retinal pigment epithelium (RPE), irregular bump or detachment of RPE and disordered RPE were 63.0%, 37.0%, 0.0% in group A; 41.9%, 53.5%, 4.7% in group B and 24.2%, 57.6%, 18.2% in group C, respectively. The difference of percentage of RPE structure was no significance among the three groups (χ2=19.88, P=0.001). The outer nuclear layer (ONL) thickness was (220.42±49.88), (145.81±19.65), (98.15±33.02) μm in group A, B, C respectively, the difference between three groups was significant (P=0.000). The BCVA differences in different RPE structure and the relationship between ONL thickness and vision prognosis were recorded and analyzed. ResultsThe difference of ONL thickness in eyes with regular RPE and irregular bump or detachment of RPE in group A, B and C were not significant (P=0.599, 0.151, 0.789). The ONL thickness in eyes with disordered RPE were decreased significantly compared to eyes with irregular bump or detachment of RPE in group B and C (P=0.025, 0.036). The ONL thickness were (139.14±26.23), (119.14±21.09), (97.61±29.92) μm after PDT, respectively. Compared with ONL thickness before PDT, there was statistically significant decreasing after PDT in group A and B (P=0.000, 0.010), but there was no statistically significant difference after PDT in group C (P=0.192). After PDT, BCVA was negatively related to ONL thickness before PDT in group A (r=-0.684, P=0.000), and was positively related to ONL thickness after PDT in group C (r=0.413, P=0.017), but was neither related to ONL thickness before nor after PDT in group C (r=0.278, 0.117; P=0.074, 0.462). ConclusionsWith the duration of symptom being longer, the rate of irregular bump or detachment of RPE and disordered RPE are increased gradually, ONL thickness is getting thinner. After PDT, the ONL thickness became thinner in eyes with symptom duration less than 6 months and has no difference in eyes with symptom duration more than 6 months. The difference of BCVA in eyes with different RPE structure is significant. The vision prognosis of CSC with duration less than 4 months or more than 6 months are related to ONL thickness.