Estabrook Elizabeth J, Madhusudhana Krishnappa C, Hannan Shabeeba R, Newsom Richard S B
University of Southampton, Southampton, United Kingdom.
Ophthalmic Surg Lasers Imaging. 2007 Nov-Dec;38(6):478-83. doi: 10.3928/15428877-20071101-06.
To assess the outcome of laser photocoagulation in patients with diabetic macular edema.
Forty-seven patients (51 eyes) with clinically significant macular edema (CSME) undergoing grid laser photocoagulation were included. Clinical examination and optical coherence tomography (OCT) were performed at baseline and 3 to 4 months after treatment. The central foveal thickness, mean inner macular thickness (average retinal thickness in fovea and inner macular circle), and mean macular thickness were calculated. Based on the greatest OCT thickness at baseline, patients were grouped according to mild (< 300 microm; Group 1), moderate (300 to 399 microm; Group 2), and severe (> or = 400 microm; Group 3) macular edema.
Group 2 showed significant reductions in central foveal thickness (23 microm, P = .02), mean inner macular thickness (18 microm, P = .02), and mean macular thickness (9 microm, P = .04) with slight improvement in visual acuity. Groups 1 and 3 did not show any significant change in macular thickness values and there was a statistically insignificant worsening of visual acuity in these groups.
Patients with moderate macular thickening of 300 to 400 microm benefit most from laser treatment. OCT may help in choosing the appropriate treatment for CSME based on the degree of macular thickening. Long-term studies are warranted to confirm these findings.
评估糖尿病性黄斑水肿患者激光光凝治疗的效果。
纳入47例（51只眼）接受格栅样激光光凝治疗的具有临床意义的黄斑水肿（CSME）患者。在基线期及治疗后3至4个月进行临床检查和光学相干断层扫描（OCT）。计算中心凹厚度、黄斑平均内层厚度（中心凹及黄斑内层环的平均视网膜厚度）和黄斑平均厚度。根据基线期OCT测得的最大厚度，将患者分为轻度（<300微米；第1组）、中度（300至399微米；第2组）和重度（≥400微米；第3组）黄斑水肿。
第2组中心凹厚度显著降低（23微米，P = .02），黄斑平均内层厚度降低（18微米，P = .02），黄斑平均厚度降低（9微米，P = .04），视力有轻微改善。第1组和第3组黄斑厚度值无显著变化，且这两组视力有统计学上无显著意义的恶化。
黄斑增厚300至400微米的中度患者从激光治疗中获益最大。OCT可根据黄斑增厚程度帮助选择合适的CSME治疗方法。需要长期研究来证实这些发现。
