[关键词]
[摘要]
目的：探讨应用532倍频激光阈值下光凝治疗糖尿病性黄斑水肿(diabetic edema，DME)的临床效果。
方法：选取非增殖期的弥漫性DME患者32例57眼，按随机化原则分为实验组和对照组，实验组采用阈值能量的80%进行黄斑区格栅样光凝，对照组采用阈值激光进行光凝，两组除能量不同外，其他的激光治疗参数均一致。两组患者均在光凝前、光凝后1wk； 1，3mo进行视力、OCT、眼底检查； 在光凝前、光凝后3mo进行FFA检查； 并对这些检查结果进行对比分析。
结果：光凝后1mo，实验组的眼视力提高占11.1%，不变占66.7%，下降占22.2%，对照组中提高占13.3%，不变占63.3%，下降占23.3%； 实验组黄斑水肿部分吸收占40.7%，不吸收占59.3%，对照组黄斑水肿完全吸收占6.7%，部分吸收占53.3%，不吸收占40.0%。实验组在视力提高和黄斑水肿吸收两方面均比对照组差，但差异没有统计学意义(P>0.05)。光凝后3mo，实验组在视力提高和黄斑水肿吸收两方面数据接近，差异没有统计学意义(P>0.05)。
结论：阈值下激光光凝治疗DME可取得和阈值激光相似的治疗效果，并可减少激光对视网膜的损害。
[Key word]
[Abstract]
AIM: To explore the clinical application effect of 532 laser subthreshold photocoagulation for diabetic macular edema(DEM).
METHODS: Fifty-seven eyes of 32 diabetes patients with diffuse macular edema of non-proliferative diabetic retinopathy were randomized to experimental group and control group. The subthreshold laser photocoagulation was performed in the experimental group, and the threshold laser photocoagulation in control group. The effect evaluation of photocoagulation included visual acuity, fundus examination, optical coherence tomography at pre-treatment and various times after treatment(1 week, 1 month, 3 months), and all patients underwent fluoreseein angiography at pre-treatment and the 3rd month after treatment.
RESULTS: At the first month after photocoagulation, in the experimental group, the eye visual acuity improved accounted for 11.1%, unchanged accounted for 66.7%, vision loss accounted for 22.2%, and the eyes visual acuity improved accounted for 13.3%, unchanged accounted for 63.3%, vision loss accounted for 23.3% in the control group. There were no statistical differences in visual acuity improvement in two groups. At the first month after photocoagulation, in the experimental group, macular edema completely absorbed accounted for 0 cases, partial absorbed accounted for 40.7%, no absorbed accounted for 59.3%, and in the control group was 6.7%, 53.3%, and 40.0%. Macular edema was absorbed better in the control group than in the experimental group, but the difference was not statistically significant(P>0.05). At 3rd month after laser treatment, the data of macular edema absorbed and visual acuity improved were similar in two groups, the difference was not statistically significant(P>0.05).
CONCLUSION: The subthreshold photocoagulation for DME is as effective as classical grid laser treatment, and this method is very safe.
[中图分类号]
[基金项目]
