[2型糖尿病并发症糖尿病性视网膜病变患者的激光光凝治疗结果]

[Results of laser photocoagulation in patients with diabetic retinopathy developed as a complication of diabetes type 2].

作者信息

Wilczyński Michał, Dzivgielewski Krzysztof

机构信息

Kliniki Chorób Oczu Katedry Chorób Oczu Uniwersytetu Medycznego w Lodzi.

出版信息

Klin Oczna. 2006;108(1-3):66-9.

DOI:
Abstract

PURPOSE

Laser photocoagulation is a widely used method of treatment of diabetic retinopathy. The purpose of the work was to analyze the results of laser photocoagulation of the retina in patients with diabetic retinopathy, as a result of diabetes type 2.

MATERIAL AND METHODS

The examined group consisted of 129 patients with diabetes type 2, treated in the Regional Centre of Diabetology and Metabolic Diseases in Lódź, who underwent laser photocoagulations as a treatment of diabetic retinopathy. Patients age were 30 to 82 years old (mean age 61), had been treated for diabetes from 1 year to 47 years (mean 17 years). Laser photocoagulations were performed in 258 eyes. The evaluation of results was based on 6 months follow-up examinations after laser treatment and comprised functional results and condition of the eye fundus.

RESULTS

In the examined groups simple non proliferative diabetic retinopathy was recognized in 36 eyes (13.95%), preproliferative retinopathy in 158 eyes (61.24%) and proliferative retinopathy in 64 eyes (24.8%). Focal photocoagulations were performed in 103 eyes. Improvement in visual acuity was noted in 82 eyes (79.61%) and stabilization or improvement in the state of the eye fundus in 92 eyes (89.32%). "Grid" photocoagulation was carried out in 73 eyes, improvement in visual acuity was noted in 53 eyes (72.60%) and stabilization or improvement in the state of the eye fundus in 58 eyes (79.45%). Panretinal photocoagulation was performed in 82 eyes. Improvement or stabilization of visual acuity was observed in 46 eyes (46.10%) and stabilization of state of the eye fundus in 54 eyes (65.85%). In cases of patients with non proliferative diabetic retinopathy stabilization of visual acuity was observed in 86.11% of eyes and stabilization of the eye fundus in 94.44% of eyes. In patients with preproliferative diabetic retinopathy stabilization of visual acuity was found in 71.52% of eyes and stabilization of state of the eye fundus in 80.38% of eyes. In cases of patients with proliferative retinopathy the percentages amounted to 57.81% and 67.19%, respectively.

CONCLUSIONS

The best functional results of laser photocoagulations, as well as stabilization of state of the eye fundus were achieved in patients with non proliferative retinopathy and after focal laser photocoagulations. The least favourable results were achieved in patients with proliferative diabetic retinopathy and in patients after panretinal photocoagulations. It probably results from the intensity of retinal lesions, which were an indication for these types of photocoagulations. The achieved improvement was greater regarding anatomical results, when compared to functional results. In order, to prevent the development of diabetic lesions in the eye fundus, it is necessary to carry out regular ophthalmologic check-ups, to qualify patients for laser photocoagulations, as early as possible.

摘要

目的

激光光凝术是治疗糖尿病视网膜病变广泛应用的方法。本研究旨在分析2型糖尿病患者糖尿病视网膜病变的激光光凝治疗效果。

材料与方法

研究组由129例2型糖尿病患者组成,这些患者在罗兹糖尿病与代谢疾病区域中心接受治疗,因糖尿病视网膜病变接受激光光凝治疗。患者年龄在30至82岁之间(平均年龄61岁),糖尿病病程为1年至47年(平均17年)。共对258只眼进行了激光光凝治疗。治疗效果评估基于激光治疗后6个月的随访检查,包括视功能结果和眼底情况。

结果

在研究组中,单纯非增殖性糖尿病视网膜病变见于36只眼(13.95%),增殖前期视网膜病变见于158只眼(61.24%),增殖性视网膜病变见于64只眼(24.8%)。103只眼进行了局灶性光凝。82只眼(79.61%)视力得到改善,92只眼(89.32%)眼底状况稳定或改善。73只眼进行了“格子样”光凝,53只眼(72.60%)视力得到改善,58只眼(79.45%)眼底状况稳定或改善。82只眼进行了全视网膜光凝。46只眼(46.10%)视力得到改善或稳定,54只眼(65.85%)眼底状况稳定。在非增殖性糖尿病视网膜病变患者中,86.11%的眼视力稳定,94.44%的眼眼底状况稳定。在增殖前期糖尿病视网膜病变患者中,71.52%的眼视力稳定,80.38%的眼眼底状况稳定。在增殖性视网膜病变患者中,这两个百分比分别为57.81%和67.19%。

结论

非增殖性视网膜病变患者及接受局灶性激光光凝治疗后,激光光凝术取得了最佳的视功能结果以及眼底状况的稳定。增殖性糖尿病视网膜病变患者及接受全视网膜光凝治疗的患者效果最差。这可能是由于这些类型光凝治疗所针对的视网膜病变程度所致。与视功能结果相比,所取得的解剖学结果改善更大。为预防眼底糖尿病病变的发展,有必要定期进行眼科检查,尽早为患者安排激光光凝治疗。

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