Singerman L J, Weaver D T
Department of Ophthalmology, St Luke's Hospital, Cleveland, Ohio, USA.
Retina. 1981;1(1):18-26.
We analyzed the subgroup of juvenile diabetics with proliferative diabetic retinopathy (PDR). One hundred consecutive Diabetic Retinopathy Study (DRS) defined high-risk eyes were treated with argon laser photocoagulation. Mean age of diabetes onset was 8.1 years and mean duration was 15.9 years. Average follow-up was 36 months. All treatment failures resulting in severe visual loss (less than 5/200 vision) occurred in the second eye treated, in spite of our routinely treating the worse eye first. We delayed treating fellow eyes prior to the 1976 DRS report. We now consider prompt treatment of the fellow high-risk eye mandatory. Five patients (5.6%) suffered severe visual loss in three years compared to 10.5% in two years in the DRS for high-risk treated eyes. We conclude that more extensive treatment, perhaps 2500 to over 3000 500 micron lesions, further reduces incidence of severe visual loss beyond the reduction shown by the DRS.
我们分析了患有增殖性糖尿病视网膜病变（PDR）的青少年糖尿病患者亚组。连续100只糖尿病视网膜病变研究（DRS）定义的高危眼接受了氩激光光凝治疗。糖尿病发病的平均年龄为8.1岁，平均病程为15.9年。平均随访时间为36个月。尽管我们通常先治疗病情较重的眼睛，但所有导致严重视力丧失（视力低于5/200）的治疗失败均发生在第二只接受治疗的眼睛上。在1976年DRS报告之前，我们推迟了对另一只眼睛的治疗。我们现在认为必须立即治疗另一只高危眼。5名患者（5.6%）在三年内出现严重视力丧失，而DRS中接受治疗的高危眼在两年内的严重视力丧失发生率为10.5%。我们得出结论，更广泛的治疗，或许2500至超过3000个500微米的病变，除了DRS所显示的降低之外，还能进一步降低严重视力丧失的发生率。
