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局灶/格栅激光治疗糖尿病性黄斑水肿后视网膜血管口径的局部变化:治疗反应的衡量标准?

Localized changes in retinal vessel caliber after focal/grid laser treatment in patients with diabetic macular edema: a measure of treatment response?

机构信息

From the *Department of Ophthalmology, Odense University Hospital, Odense, Denmark; †Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; and ‡Singapore Eye Research Institute, National University of Singapore, Singapore, Singapore.

出版信息

Retina. 2013 Nov-Dec;33(10):2089-95. doi: 10.1097/IAE.0b013e3182891dda.

Abstract

PURPOSE

To compare retinal vessel caliber changes at the macula region and surrounding the optic disk after focal/grid laser treatment for diabetic macular edema.

METHODS

The study included 69 eyes from 46 patients treated with focal/grid laser for diabetic macular edema. Retinal photographs were taken <6 months before and 2 months and 12 months after focal/grid photocoagulation treatment. The diameters of retinal vessels around macula and the optic disk were measured separately before and after treatment. Optic disk and macular diameters were summarized into central retinal arteriolar and venular equivalent and macular retinal arteriolar and venular equivalent.

RESULTS

Median age and duration of diabetes was 60 years and 13 years. There was a statistically significant decrease in diameter of the macular arterioles (macular retinal arteriolar equivalent 73.5 vs. 72.0 μm, P = 0.04) and venules (macular retinal venular equivalent 63.5 vs. 62.4 μm, P = 0.02) after treatment but no difference in central retinal arteriolar equivalent or central retinal venular equivalent before and after treatment. Retinal vascular calibers in control eyes did not change throughout the study.

CONCLUSION

The diameters of macular vessels decreased after focal/grid laser treatment in most eyes. In contrast, vessel calibers at the optic disk did not change. Quantitative measurement of macular vessels may allow physicians to monitor the progress and success of diabetic macular edema treatment.

摘要

目的

比较糖尿病黄斑水肿患者接受局部/格栅激光治疗后黄斑区和视盘周围视网膜血管口径的变化。

方法

本研究纳入了 46 例 69 只眼接受局部/格栅激光治疗的糖尿病黄斑水肿患者。在接受局部/格栅光凝治疗前 6 个月内以及治疗后 2 个月和 12 个月拍摄视网膜照片。在治疗前后分别测量黄斑区和视盘周围视网膜血管的直径。将视盘和黄斑直径汇总为中心视网膜小动脉和小静脉等效直径和黄斑视网膜小动脉和小静脉等效直径。

结果

中位年龄和糖尿病病程分别为 60 岁和 13 年。治疗后黄斑小动脉(黄斑视网膜小动脉等效直径 73.5μm 比 72.0μm,P=0.04)和小静脉(黄斑视网膜小静脉等效直径 63.5μm 比 62.4μm,P=0.02)的直径均有统计学显著下降,但治疗前后中心视网膜小动脉等效直径或中心视网膜小静脉等效直径无差异。对照眼的视网膜血管直径在整个研究过程中均无变化。

结论

大多数患者接受局部/格栅激光治疗后黄斑区血管直径减小。相比之下,视盘处的血管口径没有变化。对黄斑区血管的定量测量可能有助于医生监测糖尿病黄斑水肿治疗的进展和疗效。

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