Kojima K, Yamagishi Z, Shimizu Y, Fujikura K, Ikema T, Saito Y, Harada T
Dept. of Ophthalmol. Fukui Medical School, Japan.
Nippon Ganka Gakkai Zasshi. 1990 Jan;94(1):54-60.
Retrospective analysis of clinical cases observed for three years with respect to the appearance of the fundus and visual acuity was conducted to evaluate the effect of photocoagulation therapy on macular edema in relation to whither diabetic retinopathy was accompanied by, focal or cystoid, macular edema. In addition to glycemic control, focal and direct treatment of responsible lesions was found effective for focal macular edema in simple diabetic retinopathy. Concerning all types of retinopathy, the prognosis of focal macular edema was significantly favorable to that of cystoid macular edema. Blood sugar control also influenced the prognosis of focal edema. The changes of retinopathy were closely associated with the prognosis of focal macular edema in preproliferative and proliferative retinopathy. Disseminated photocoagulation and panretinal photocoagulation showed no difference as to the results of indirect treatment of focal macular edema in preproliferative retinopathy. Macular alterations other than macular edema occurred in a higher proportion of cases of proliferative retinopathy than in simple or preproliferative retinopathy. This accounted for low visual recovery in the former group in comparison to simple retinopathy. It was concluded that the direct treatment of the involved lesions is effective for focal macular edema in simple retinopathy and that extensive photocoagulation in preproliferative and proliferative retinopathy indirectly has a favorable influence on focal edema by means of amelioration of retinopathy.
对观察三年的临床病例进行回顾性分析,涉及眼底外观和视力,以评估光凝治疗对黄斑水肿的效果,该效果与糖尿病性视网膜病变是否伴有局灶性或囊样黄斑水肿相关。除血糖控制外,发现对单纯糖尿病性视网膜病变中的局灶性黄斑水肿进行局灶性和直接治疗病变是有效的。关于所有类型的视网膜病变,局灶性黄斑水肿的预后明显优于囊样黄斑水肿。血糖控制也影响局灶性水肿的预后。视网膜病变的变化与增殖前期和增殖性视网膜病变中局灶性黄斑水肿的预后密切相关。在增殖前期视网膜病变中,弥漫性光凝和全视网膜光凝在局灶性黄斑水肿间接治疗结果方面无差异。与单纯性或增殖前期视网膜病变相比,增殖性视网膜病变病例中发生黄斑水肿以外的黄斑改变的比例更高。这解释了与单纯性视网膜病变相比,前一组的视力恢复较低。得出的结论是,对单纯性视网膜病变中的局灶性黄斑水肿进行受累病变的直接治疗是有效的,并且增殖前期和增殖性视网膜病变中的广泛光凝通过改善视网膜病变对局灶性水肿间接产生有利影响。