Guyer D R, D'Amico D J, Smith C W
Retina Service, Massachusetts Eye and Ear Infirmary, Boston 02114.
Am J Ophthalmol. 1992 Jun 15;113(6):652-6. doi: 10.1016/s0002-9394(14)74789-0.
Seven eyes had subretinal fibrosis after grid laser photocoagulation for diabetic macular edema. The fibrosis caused persistent loss in visual acuity, and in six of the seven eyes, was not associated with detectable laser-induced Bruch's membrane rupture or subretinal hemorrhage. Choroidal neovascularization was detected in only one patient, who was notably younger (27 years) than the median age of 70 years in this series. The median preoperative visual acuity was 20/80 (range, 20/40 to 20/400); the median postoperative visual acuity was 20/400 (range, 20/80 to counting fingers). The subretinal fibrosis was detected at a median of three months (range, 14 days to 4 1/2 months) after laser therapy. In one of five bilaterally treated patients (20%), subretinal fibrosis developed in both eyes. Subretinal fibrosis may be caused by undetected choroidal neovascularization or by excessive proliferation after stimulation of an aged retinal pigment epithelium. Subretinal fibrosis may be a potential cause of loss in visual acuity after laser treatment for diabetic macular edema.
7只眼睛在接受格栅样激光光凝治疗糖尿病性黄斑水肿后出现了视网膜下纤维化。这种纤维化导致视力持续丧失，在这7只眼睛中的6只中，与可检测到的激光诱导的 Bruch 膜破裂或视网膜下出血无关。仅1例患者检测到脉络膜新生血管，该患者明显比本系列患者的中位年龄70岁年轻（27岁）。术前视力中位数为20/80（范围为20/40至20/400）；术后视力中位数为20/400（范围为20/80至数指）。视网膜下纤维化在激光治疗后中位数3个月（范围为14天至4个半月）被检测到。在5例双侧治疗的患者中，有1例（20%）双眼均出现视网膜下纤维化。视网膜下纤维化可能由未检测到的脉络膜新生血管或老年视网膜色素上皮受到刺激后的过度增殖引起。视网膜下纤维化可能是糖尿病性黄斑水肿激光治疗后视力丧失的一个潜在原因。
