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糖尿病视网膜病变光凝术后视网膜大血管氧饱和度增加。

Increasing oxygen saturation in larger retinal vessels after photocoagulation for diabetic retinopathy.

机构信息

Department of Ophthalmology, Aarhus University Hospital, Aarhus C, Denmark.

出版信息

Invest Ophthalmol Vis Sci. 2014 Aug 5;55(8):5365-9. doi: 10.1167/iovs.14-14811.

Abstract

PURPOSE

Diabetic retinopathy is characterized by retinal vascular impairment resulting in retinal hypoxia. The disease can be treated by retinal photocoagulation, but the mechanism of action of this treatment is unknown. Therefore, it is of interest to investigate whether the effects of retinal photocoagulation are related to changes in oxygen saturation.

METHODS

Retinal oximetry and diameter measurements were performed on larger retinal arterioles and venules in 220 eyes from 149 patients with diabetic maculopathy (DM) and proliferative diabetic retinopathy (PDR) before, immediately after, and 3 months after photocoagulation treatment.

RESULTS

Before treatment oxygen saturation was increased in retinal venules in DM patients to result in reduced arteriovenous (AV) saturation difference, and was increased in arterioles and venules in PDR patients to result in a normal AV saturation difference. Immediately after treatment the oxygen saturation in both groups was unchanged in retinal arterioles and increased in retinal venules resulting in a reduced AV saturation difference. Three months after treatment arterial and venous saturations were increased, but the AV saturation difference was not different from the pretreatment level. In both patient groups vascular diameters had decreased 3 months after treatment, which was significant for venules in the PDR group.

CONCLUSIONS

The effects of retinal photocoagulation on diabetic retinopathy are not correlated with changes in oxygen saturation in larger retinal vessels.

摘要

目的

糖尿病性视网膜病变的特征是视网膜血管损伤导致视网膜缺氧。该疾病可以通过视网膜光凝术治疗,但这种治疗的作用机制尚不清楚。因此,研究视网膜光凝术的效果是否与氧饱和度的变化有关是很有意义的。

方法

在 149 名糖尿病性黄斑病变(DM)和增殖性糖尿病性视网膜病变(PDR)患者的 220 只眼中,对较大的视网膜小动脉和小静脉进行视网膜血氧测定和直径测量,在光凝治疗前、治疗后即刻和 3 个月后进行。

结果

治疗前,DM 患者的视网膜静脉血氧饱和度增加,导致动静脉(AV)饱和度差减小,PDR 患者的小动脉和小静脉血氧饱和度增加,导致正常的 AV 饱和度差。治疗后即刻,两组的视网膜小动脉血氧饱和度均无变化,而视网膜小静脉的血氧饱和度增加,导致 AV 饱和度差减小。治疗 3 个月后,动脉和静脉的血氧饱和度均升高,但 AV 饱和度差与治疗前无差异。在这两个患者组中,治疗 3 个月后血管直径减小,PDR 组的小静脉更为显著。

结论

视网膜光凝术对糖尿病性视网膜病变的影响与较大视网膜血管中氧饱和度的变化无关。

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