Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea.
Retina. 2010 May;30(5):756-60. doi: 10.1097/IAE.0b013e3181c701e0.
The purpose of this study was to investigate changes in macular thickness after panretinal photocoagulation (PRP) in patients with severe diabetic retinopathy (DR) without macular edema and to compare the visual acuity outcomes.
This prospective cohort study included 30 patients with severe nonproliferative DR or non-high-risk proliferative DR whose visual acuity was > or =0.8 before PRP. Sixty eyes of 30 patients with severe nonproliferative DR or non-high-risk proliferative DR received biweekly PRP treatment in 4 sessions. Macular thickness and visual acuity were measured before and at 1, 3, 6, and 12 months after PRP.
The visual acuities were 0.02 +/- 0.11 before PRP and 0.04 +/- 0.11, 0.04 +/- 0.07, 0.02 +/- 0.07, and 0.04 +/- 0.08 at 1, 3, 6, and 12 months after PRP, respectively (P > 0.05 for each). Central macular thickness was increased at 1 (223.3 +/- 40.6 microm), 3 (216.8 +/- 23.5 microm), 6 (219.4 +/- 33.1 microm), and 12 months (220.4 +/- 17.3 microm) after PRP compared with that before PRP (199.0 +/- 20.9 microm; P < 0.05 for each).
Biweekly PRP (1,200-1,600 spots) had no effect on visual acuity in patients with severe DR without macular edema, which was determined by clinical and optical coherence tomography examination, although mild macular thickening frequently persists.
本研究旨在观察无黄斑水肿的重度糖尿病视网膜病变（DR）患者行全视网膜光凝（PRP）后黄斑厚度的变化，并比较视力结果。
本前瞻性队列研究纳入了 30 例视力 >或=0.8 的重度非增生性 DR 或非高危增生性 DR 患者，60 只眼行 PRP 治疗，其中 30 例患者行 4 次、每 2 周 1 次的 PRP。在 PRP 治疗前及治疗后 1、3、6 和 12 个月时测量黄斑厚度和视力。
PRP 治疗前患者视力为 0.02 +/- 0.11，治疗后 1、3、6 和 12 个月时分别为 0.04 +/- 0.11、0.04 +/- 0.07、0.02 +/- 0.07 和 0.04 +/- 0.08（P > 0.05）。治疗后 1、3、6 和 12 个月时中央黄斑厚度分别为 223.3 +/- 40.6 μm、216.8 +/- 23.5 μm、219.4 +/- 33.1 μm和 220.4 +/- 17.3 μm，均高于 PRP 治疗前的 199.0 +/- 20.9 μm（P < 0.05）。
通过临床和光学相干断层扫描检查发现，无黄斑水肿的重度 DR 患者行每 2 周 1 次、1,200-1,600 个光斑的 PRP 治疗后视力无变化，但常出现轻度黄斑增厚。
