中心性浆液性脉络膜视网膜病变（二）

治疗：

部分的中浆患者不用任何治疗3个月内可自愈，自愈后中心视力可恢复正常。但有些患者反复多次发作，长年迁延不愈，形成广泛的色素上皮继发性改变，甚至出现黄斑下机化膜，导致视力大幅度减退甚至永久性丧失。目前关于中浆的治疗措施和时机，还都存在争议。主要的治疗方法有：

1.常规西医药物治疗由于本病确切发病原因不明，目前缺乏针对性的有效药物治疗。大量临床实践证明，激素使用后可加重病情，可发生大泡性视网膜脱离，应避免使用。皮质激素致病变加重的机制不明，推测可能是激素使视网膜色素上皮细胞间的封闭小带松解所致，也可能激素作为免疫抑制剂抑制免疫反应，导致视网膜色素上皮细胞进一步损害和屏障功能破坏而引起。烟酸作为血管扩张剂应用于本病，有可能加重血管渗漏，引起黄斑水肿，延长病程，甚至引起大泡状视网膜脱离，也不宜使用。应用乙酰唑胺治疗中心性浆液性视网膜病变可缩短主观视力改善时间和水肿消退时间，对最终视力无影响，也不影响疾病的复发率，但需注意药物的不良反应。其作用机制主要是通过视网膜下间隙酸化，减少静止电位，增加视网膜黏附性，有助于视网膜下液吸收；或通过抑制视网膜色素上皮的碳酸酐酶，重建视网膜色素上皮极性，促进液体转运吸收，也可能通过抑制眼组织中γ-谷氨酸转肽酶活性，促进细胞黏附、粒细胞趋化和细胞变性，以达到抗炎作用。

2.光凝治疗光凝治疗是目前治疗中浆较有效，有助于视力的恢复，但并不能减少或预防复发。并且会损伤视网膜局部血液循环。造成视网膜萎缩斑，进而导致视野缺损。

并发症

色素上皮萎缩、脉络膜新生血管及大泡性视网膜脱离。

魏氏中医眼科的治疗方案：

对与治疗中浆，由于该病常见多发。治疗临床经验已经相当丰富。该病大体分为以下三种类型：

1、水湿上泛型症见视物模糊，眼前出现有色阴影，视物变小或变形，眼底可见视网膜反光，晕轮明显，黄斑水肿，中心凹光反射减弱或消失; 胸闷，纳呆呕恶，大便稀溏; 舌苔滑腻，脉濡或滑。治宜利水渗湿加减。

2 、痰湿化热型症见视物模糊，眼前棕黄色阴影，视物变小或变形，眼底可见黄斑水肿及黄白色渗出; 脘腹痞满，纳呆呕恶，小便短赤; 舌红苔黄腻，脉濡数。治宜舒肝解郁、健脾利湿法加减。

3 、肝肾不足型症见视物模糊，眼前可见暗灰色阴影，视物变小或变形，眼底可见黄斑区色素紊乱，少许黄白色渗出，中心凹光反射减弱；可兼见头晕耳鸣，梦多滑遗，腰膝酸软; 舌红少苔，脉细。治宜滋补肝肾、和血明目法加减总之临证时辨证与辨病相结合，整体调节与对症处理相结合，是中医治疗中心性浆液性脉络膜视网膜病变的根本。

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The cornea is the eye's outermost layer. It is dome-shaped surface front part of the eye that covers the iris, pupil, and anterior chamber.

Glaucoma Services

Glaucoma is a group of eye diseases which result in damage to the optic nerve and vision loss. A major risk factor is increased pressure in the eye.

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Cornea Services

The cornea is the eye's outermost layer. It is dome-shaped surface front part of the eye that covers the iris, pupil, and anterior chamber.

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Glaucoma is a group of eye diseases which result in damage to the optic nerve and vision loss. A risk factor is increased pressure in eye.

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How often should I have my eyes tested?

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Is there a high risk of eye infection if I wear contact lenses?

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I'm diabetic but my vision hasn't changed. Why do I need an eye test every year?

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Glasses required after laser eye surgery ?

What are the signs and symptoms of corneal disease?

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How often should I have my eyes tested?

Is there a high risk of eye infection if I wear contact lenses?

I'm diabetic but my vision hasn't changed. Why do I need an eye test every year ?

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Glasses required after laser eye surgery ?

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Visual acuity test
Retinoscopy & Refraction testing
Ophthalmoscope & slit lamp test
Non-contact Tonometer & Tonopen test
Digital Retinal Photography & Visual field screener

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