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[氩激光光凝术对糖尿病视网膜病变的影响]

[Effect of argon laser photocoagulation on diabetic retinopathy].

作者信息

Wei Zhan-yun, Hu Shi-xing, Tang Na, Wu Jing, Wang Jie

机构信息

Detartment of Ophthalmology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

出版信息

Di Yi Jun Yi Da Xue Xue Bao. 2004 Nov;24(11):1313-5.

Abstract

OBJECTIVE

To observe the clinical effect of argon laser photocoagulation on diabetic retinopathy (DR) in different stages.

METHODS

A total of 263 eyes in 170 patients with DR in different stages were photocoagulated using argon laser machine 2000. Thirty eyes in non-proliferative stage received focal photocoagulation, 156 pre-proliferative eyes received subtotal panretina photocoagulation, and 77 proliferative eyes were treated with panretinal photocoagulation. Additional focal or grid treatment was given for the eyes with localized or diffused macular edema. The visual acuity, eye fundus examination and retinal fluorescein angiography were carried out 3 months after the treatment and the results compared with the preoperative findings.

RESULTS

Improvement of visual acuity by at least one row on the visual chart was achieved in 92 eyes (35%), 144 eyes (55%) exhibited no changes, and 27 eyes (10%) deteriorated. Microaneurysm, retinal edema, exudates and fluorescence leakage were reduced in 89% of the eyes, with the rest eyes requiring additional treatment in the non-proliferative and pre-proliferative stages. For the retina in proliferative stage, neovascularization on the disc resolved completely in 67% eyes, whereas partially in 33% eyes which needed additional photocoagulation. The eyes with partial and complete resolution of macular edema accounted for 91% of the total eyes. Postoperative pre-retinal hemorrhage and vitreous hemorrhage occurred at the rates of 8% and 1%, respectively.

CONCLUSION

Argon laser therapy is effective for the eyes with DR in different stages, but produces better efficacy in non- and pre-proliferative stages than in proliferative stage. Follow-up and additional photocoagulation are necessary for the eyes in proliferative stage to ensure better outcome.

摘要

目的

观察氩激光光凝治疗不同阶段糖尿病视网膜病变(DR)的临床效果。

方法

使用2000型氩激光机对170例不同阶段DR患者的263只眼进行光凝治疗。非增殖期30只眼行局部光凝,增殖前期156只眼行次全视网膜光凝,增殖期77只眼行全视网膜光凝。对伴有局限性或弥漫性黄斑水肿的眼加用局部或格栅样光凝治疗。治疗3个月后进行视力、眼底检查及视网膜荧光血管造影,并与术前结果进行比较。

结果

92只眼(35%)视力至少提高一行视标,144只眼(55%)视力无变化,27只眼(10%)视力下降。89%的眼微动脉瘤、视网膜水肿、渗出及荧光渗漏减少,非增殖期和增殖前期其余眼需追加治疗。增殖期视网膜,视盘新生血管完全消退的眼占67%,部分消退的眼占33%,后者需追加光凝治疗。黄斑水肿部分及完全消退的眼占总眼数的91%。术后视网膜前出血和玻璃体出血发生率分别为8%和1%。

结论

氩激光治疗不同阶段的DR有效,但在非增殖期和增殖前期的疗效优于增殖期。增殖期的眼需要随访及追加光凝治疗以确保更好的治疗效果。

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