Pulido J S, Mieler W F, Walton D, Kuhn E, Postel E, Hartz A, Jampol L M, Weinberg D V, Logani S
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, USA.
Trans Am Ophthalmol Soc. 1998;96:127-37; discussion 137-41.
To determine the effect of peripheral retinal laser photocoagulation (PLP) on visual acuity, intraocular inflammation, and other ocular findings, including retinal neovascularization in eyes with pars planitis.
A retrospective chart review of eyes with pars planitis that had undergone PLP.
Twenty-two eyes in 17 patients with pars planitis had undergone treatment with PLP at 2 centers. The mean age at the time of treatment was 19.3 years. Following treatment, mean follow-up was 16.3 months (range, 6 to 37 months). Mean visual acuity was 20/60 preoperatively and 20/50 postoperatively. This level of improvement was not statistically significant (P > .10), but there was a statistically significant decrease in the use of corticosteroids between the preoperative examination and the last postoperative examination (86% versus 27%, P < .05). There was also a statistically significant decrease in vitritis at the last follow-up (P = .0008) and a decrease in neovascularization of the vitreous base (P = .03) and in clinically apparent cystoid macular edema (P = .02). Epiretinal membranes were noted in 23% of eyes preoperatively and in 45% of eyes postoperatively. Only one of these epiretinal membranes was considered to be visually significant. One eye developed a tonic dilated pupil, which slowly improved.
Although the long-term natural history of clinical findings in pars planitis is not well documented, PLP appears to decrease the need for corticosteroids while stabilizing visual acuity. It also appears to decrease vitreous inflammation. PLP has few complications and should be considered in patients with pars planitis who are unresponsive or have adverse reactions to corticosteroids.
确定周边视网膜激光光凝术(PLP)对视力、眼内炎症及其他眼部表现的影响,包括中间葡萄膜炎患者的视网膜新生血管形成情况。
对接受PLP治疗的中间葡萄膜炎患者的病历进行回顾性分析。
17例中间葡萄膜炎患者的22只眼在2个中心接受了PLP治疗。治疗时的平均年龄为19.3岁。治疗后,平均随访时间为16.3个月(范围6至37个月)。术前平均视力为20/60,术后为20/50。这种改善程度无统计学意义(P>.10),但术前检查与最后一次术后检查相比,皮质类固醇的使用有统计学意义的减少(86%对27%,P<.05)。最后一次随访时玻璃体炎也有统计学意义的减轻(P =.0008),玻璃体基底部新生血管形成减少(P =.03),临床明显的黄斑囊样水肿减少(P =.02)。术前23%的眼有视网膜前膜,术后45%的眼有视网膜前膜。这些视网膜前膜中只有1例被认为具有视力影响。1只眼出现强直性瞳孔散大,后逐渐改善。
虽然中间葡萄膜炎临床发现的长期自然病程记录不详,但PLP似乎在稳定视力的同时减少了皮质类固醇的使用需求。它似乎还能减轻玻璃体炎症。PLP并发症少,对于对皮质类固醇无反应或有不良反应的中间葡萄膜炎患者应考虑使用。