Ohkoshi Kishiko
Department of Ophthalmology, St. Luke's International Hospital, Tokyo, Japan.
Nippon Ganka Gakkai Zasshi. 2005 Apr;109(4):210-7.
To investigate the efficacy of photocoagulation for diffuse diabetic macular edema.
One hundred and fifty eyes with diffuse diabetic macular edema were treated by laser photocoagulation (grid pattern photocoagulation, in some instances combined with direct photocoagulation) and followed up more than 1 year. The visual prognosis of these cases was retrospectively studied.
The logarithm of the minimum angle of resolution (Log MAR) final visual acuity after photocoagulation was improved more than 0.2 levels in 62 eyes (41%) of a total 150 eyes, and in 60% of 87 eyes in which preoperative visual acuity had been less than 0.5. Average visual acuity after photocoagulation reached a plateau within three months after surgery, and 84% of the eyes with 0.5 or better preoperative visual acuity achieved 0.5 or better final visual acuity. There was correlation between visual prognosis and the following preoperative factors: preoperative visual acuity, hard exudates, fluorescein leakage, grid area, hyperlipidemia, and renal failure.
Grid photocoagulation as a treatment for diffuse diabetic macular edema is effective to improve or maintain visual acuity. Alternative treatment such as vitrectomy should be considered after three-month observation on the outcome of grid photocoagulation.
探讨光凝治疗弥漫性糖尿病性黄斑水肿的疗效。
对150例弥漫性糖尿病性黄斑水肿患者的患眼行激光光凝治疗（格栅样光凝，部分联合直接光凝），并随访1年以上。对这些病例的视力预后进行回顾性研究。
150眼中62眼（41%）光凝术后最小分辨角对数（Log MAR）视力提高超过0.2级，术前视力低于0.5的87眼中60%达到此效果。光凝术后平均视力在术后3个月内达到平台期，术前视力0.5及以上的患眼中84%最终视力达到0.5及以上。视力预后与以下术前因素相关：术前视力、硬性渗出、荧光素渗漏、格栅面积、高脂血症及肾衰竭。
格栅样光凝治疗弥漫性糖尿病性黄斑水肿对提高或维持视力有效。在对格栅样光凝治疗效果进行3个月观察后，应考虑玻璃体切割术等替代治疗。
