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血管性疾病的局灶导航激光光凝治疗:初步病例系列的临床结果。

Focal navigated laser photocoagulation in retinovascular disease: clinical results in initial case series.

机构信息

Department of Ophthalmology, Jacobs Retina Center, Shiley Eye Center, University of California San Diego, La Jolla, California 92037, USA.

出版信息

Retina. 2012 May;32(5):930-5. doi: 10.1097/IAE.0b013e318227ab5b.

Abstract

PURPOSE

To evaluate clinical results after the use of a novel integrated imaging and laser device to perform focal retinal navigated laser photocoagulation in perifoveal abnormalities and retinovascular disease.

METHODS

Interventional case series of 25 consecutive eyes with perifoveal and retinovascular diseases treated with a navigated laser photocoagulator Navilas (OD-OS, Berlin, Germany). We treated eyes with perifoveal telangiectasia (n = 3), central serous chorioretinopathy (n = 2), and diabetic macular edema with focal leakage (n = 20).

RESULTS

The treatments were performed without a contact lens and without topical anesthesia. There was no inadvertent photocoagulation of the fovea, and all laser applications accurately hit the preplanned points. Mean and median (± standard deviation) foveal thickness at baseline was 535 ± 171 μm and 402 ± 152 μm, respectively. Mean and median (± standard deviation) foveal thickness at 6 months was 318 ± 112 μm and 221 ± 127 μm, respectively. This represents a statistically significant decrease in foveal thickness (P = 0.003). Mean and median visual acuity at baseline was 20/80 and 20/50, respectively. Mean and median visual acuity at 6 months was 20/50 and 20/40, respectively, which represents a significant improvement (P = 0.011).

CONCLUSION

Precise retinal targeting with a navigated laser photocoagulator resulted in highly accurate perifoveal laser application and no foveal damage. At 6 months after the treatment, significant decreases in central foveal thickness and significant improvements in visual acuity were identified.

摘要

目的

评估一种新型集成成像和激光设备在周边病变和血管性疾病中进行局灶性视网膜导航激光光凝的临床效果。

方法

对 25 例周边和血管性疾病患者的连续 25 只眼进行了干预性病例系列研究,这些患者使用导航激光光凝器 Navilas(OD-OS,德国柏林)进行治疗。我们治疗了周边毛细血管扩张症(n = 3)、中心性浆液性脉络膜视网膜病变(n = 2)和伴有局灶性渗漏的糖尿病性黄斑水肿(n = 20)的患者。

结果

无需接触镜和局部麻醉即可进行治疗。没有无意中对黄斑进行光凝,所有激光应用均准确地击中了预先计划的点。基线时平均和中位数(±标准差)黄斑中心凹厚度分别为 535 ± 171μm 和 402 ± 152μm。6 个月时平均和中位数(±标准差)黄斑中心凹厚度分别为 318 ± 112μm 和 221 ± 127μm,分别表示有统计学意义的黄斑中心凹厚度减少(P = 0.003)。基线时平均和中位数视力分别为 20/80 和 20/50。6 个月时平均和中位数视力分别为 20/50 和 20/40,这表明视力显著提高(P = 0.011)。

结论

使用导航激光光凝器进行精确的视网膜靶向治疗可实现高度准确的周边激光应用,且不会造成黄斑损伤。治疗 6 个月后,发现中央黄斑中心凹厚度显著降低,视力显著提高。

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