不同激光光凝术治疗增殖期糖尿病性视网膜病变观察
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Proliferative diabetic retinopathy observed after laser photocoagulation
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    摘要:

    目的:观察采取不同激光光凝术治疗糖尿病性视网膜(diabetic retinopathy,DR)以及预后的关系。

    方法:回顾分析2010-11/2012-11进行激光治疗的增殖期糖尿病性视网膜(proliferative diabetic retinopathy,PDR)患者98例153眼,分为3组, A组:38眼(25%)给予全视网膜激光光凝术,B组: 55眼(36%)给予象限视网膜激光光凝术,C组: 60眼(39%)给予缺血区视网膜激光光凝术。所有病例手术前后均进行了血糖、验光、眼压、视野、视觉诱发电位(visual evoked potential,VEP)、视网膜电图(electroretinogram,ERG)、眼底血管荧光造影(fundus fluorescence antiography,FFA)、光学相干断层扫描(optical coherence tomography,OCT)的检查,术后随访3mo。

    结果:术后3mo,复查患眼OCT,与C组相比,A组和B组,黄斑厚度减少(P<0.05); 视力提高3行以上纳入统计,与A组相比,B组和C组术后视力改善(P<0.05)。

    结论:对视网膜缺血区进行象限视网膜激光光凝术,可以明显改善视网膜缺氧状态,阻止视网膜新生血管的生长,而且保护了黄斑区视功能。

    Abstract:

    AIM: To evaluatethe laser photocoagulation of different ranges for diabetic retinopathy(DR)prognosis.

    METHODS: A total of 98 cases(153 eyes)with proliferative diabetic retinopathy treated by laser photocoagulation from November 2010 to November 2012 were enrolled in this study. The eyes were divided into three groups, Group A of 38 eyes(25%)receiving pan-retinal photocoagulation, group B of 55 eyes(36%)receiving quadrant retinal laser photocoagulation and group C 60 eyes(39%)receiving retinal laser photocoagulation only in the ischemic area. Blood glucose, refraction, intraocular pressure and vision were measured preoperatively and postoperatively. And all patients underwent VEP, ERG, fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)examinations before and after operation. Patients were followed up for 3 months.

    RESULTS: After 3 months, decrease of macular thickness in group A and B was more significant than that in group C(P<0.05); improvement of visual acuity in group B and C(3 or more lines)was more significant than that in group A(P<0.05).

    CONCLUSION: Quadrant retinal laser photocoagulation can significantly improve retinal hypoxia, prevent retinal neovascularization and protect visual function in macular area.

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郭勇,刘燕,张少波.不同激光光凝术治疗增殖期糖尿病性视网膜病变观察.国际眼科杂志, 2013,13(11):2333-2335.

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  • 收稿日期:2013-07-15
  • 最后修改日期:2013-10-09
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  • 在线发布日期: 2013-10-28
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