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[格栅激光光凝治疗弥漫性糖尿病性黄斑水肿]

[Grid laser photocoagulation in diffuse diabetic macular edema].

作者信息

Degenring Robert F, Hugger Philipp, Sauder Gangolf, Jonas Jost B

机构信息

Univ.-Augenklinik Mannheim, Fakultät für Klinische Medizin Mannheim, Ruprecht-Karls-Universität Heidelberg.

出版信息

Klin Monbl Augenheilkd. 2004 Jan;221(1):48-51. doi: 10.1055/s-2003-812638.

Abstract

BACKGROUND

To evaluate the clinical outcome of macular grid laser photocoagulation in the treatment of diffuse diabetic macular oedema.

PATIENTS AND METHOD

The retrospective study included 30 consecutive patients (41 eyes) who were treated by macular argon green grid laser photocoagulation for diffuse diabetic macular oedema. Follow-up time was 31.4 +/- 19.6 weeks.

RESULTS

Visual acuity decreased from 0.25 +/- 0.18 (range, 0.03 - 0.8) to 0.20 +/- 0.18 (range, 0.02 - 0.8) (P = 0.045), representing a change of - 0.9 +/- 2,32 lines. 5 (12.2 %) eyes gained in visual acuity, visual acuity remained unchanged for 23 (56.1 %) eyes, and 13 (31.7 %) eyes showed a visual loss of more than one line. In eyes with a baseline visual acuity > or = 0.2 (N = 24) visual acuity dropped from 0.36 +/- 0.15 (0.2 - 0.8; median 0.3) to 0.29 +/- 0.19 (0.05 - 0.8; median 0.2) (p = 0.038). 3 eyes (12.5 %) gained > or = 2 lines, 11 eyes (45.8 %) lost > or = 2 lines, 10 eyes (41.7 %) remained stable. Mean loss was - 1.63 +/- 2.53 lines. Eyes with a baseline visual acuity < or = 0.2 did not change significantly.

CONCLUSION

In the present study mean visual acuity decreased in the whole population and especially in the subgroup with a baseline visual acuity of > or = 0.2 after macular grid laser photocoagulation for diffuse diabetic macular oedema. Mean visual loss was just below the predefined 2 lines. In view of these results and upcoming new pharmacological and surgical treatment modalities, the significance of grid laser photocoagulation should be re-discussed.

摘要

背景

评估黄斑格栅激光光凝术治疗弥漫性糖尿病性黄斑水肿的临床疗效。

患者与方法

这项回顾性研究纳入了30例连续患者(41只眼),这些患者均接受了黄斑氩绿格栅激光光凝术治疗弥漫性糖尿病性黄斑水肿。随访时间为31.4±19.6周。

结果

视力从0.25±0.18(范围0.03 - 0.8)降至0.20±0.18(范围0.02 - 0.8)(P = 0.045),相当于下降了 - 0.9±2.32行。5只眼(12.2%)视力提高,23只眼(56.1%)视力不变,13只眼(31.7%)视力下降超过1行。在基线视力≥0.2的眼中(N = 24),视力从0.36±0.15(0.2 - 0.8;中位数0.3)降至0.29±0.19(0.05 - 0.8;中位数0.2)(p = 0.038)。3只眼(12.5%)视力提高≥2行,11只眼(45.8%)视力下降≥2行,10只眼(41.7%)保持稳定。平均下降为 - 1.63±2.53行。基线视力≤0.2的眼无显著变化。

结论

在本研究中,对于弥漫性糖尿病性黄斑水肿行黄斑格栅激光光凝术后,总体人群尤其是基线视力≥0.2的亚组平均视力下降。平均视力下降略低于预先定义的2行。鉴于这些结果以及即将出现的新的药物和手术治疗方式,应重新讨论格栅激光光凝术的意义。

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