使用模式扫描激光对糖尿病性视网膜病变进行全视网膜光凝前后视网膜血流的评估。

Evaluation of retinal blood flow before and after panretinal photocoagulation using pattern scan laser for diabetic retinopathy.

作者信息

Yamada Yoshihisa, Suzuma Kiyoshi, Onizuka Naoko, Uematsu Masafumi, Mohamed Yasser Helmy, Kitaoka Takashi

机构信息

a Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences , Nagasaki University, Nagasaki, Japan.

b Department of Ophthalmology and Visual Sciences, Graduate School of Medicine , Kyoto University, Kyoto, Japan.

出版信息

Curr Eye Res. 2017 Dec;42(12):1707-1712. doi: 10.1080/02713683.2017.1358373. Epub 2017 Sep 22.

DOI:10.1080/02713683.2017.1358373

PMID:28937857

Abstract

PURPOSE

Laser speckle flowgraphy (LSFG) can measure blood flow in the ocular fundus. We analyzed the relationship between retinal blood flow and panretinal photocoagulation (PRP) in diabetic retinopathy.

METHODS

This retrospective observational study examined the eyes of 35 patients with proliferative diabetic retinopathy (PDR) or non-PDR (NPDR). PRP was performed using a pattern scan laser. Using LSFG, blood flow was evaluated as the mean blur rate (MBR) or the relative flow volume (RFV). We also evaluated MBR in the vessels of the optic nerve head (MBR-V), RFV at the first retinal artery (RFV-A), and RFV at the first retinal vein (RFV-V) before bifurcation. Blood flows were measured prior to treatment initiation, during each PRP session, and after PRP.

RESULTS

The total number of laser spots created was 4258 ± 461. Regression of neovascular activity at 6 months after PRP occurred in 29 (82.85%) eyes. MBR-V significantly decreased to 83.9 ± 16% (p = .0039), 79.3 ± 21% (p = .0001), and 73.5 ± 26% (p = .0001) after the first, second, and third PRP treatment sessions. MBR-V was also reduced to 75.0 ± 25% (p = .0001), 75.0 ± 25% (p = .0001), and 80.3 ± 22% (p = .0001) at 1, 3, and 6 months following PRP. During and at 6 months after the PRP treatments, RFV-A and RFV-V were also significantly reduced (p< .01).

CONCLUSIONS

During and after PRP treatments using pattern scan laser, retinal blood flow was reduced. Retinal blood flow may be an auxiliary measurement for effectively evaluating PRP or PDR.

摘要

目的

激光散斑血流图（LSFG）可测量眼底血流。我们分析了糖尿病性视网膜病变中视网膜血流与全视网膜光凝（PRP）之间的关系。

方法

这项回顾性观察研究检查了35例增殖性糖尿病性视网膜病变（PDR）或非增殖性糖尿病性视网膜病变（NPDR）患者的眼睛。使用模式扫描激光进行PRP。使用LSFG，将血流评估为平均模糊率（MBR）或相对血流量（RFV）。我们还评估了视神经乳头血管中的MBR（MBR-V）、视网膜第一动脉处的RFV（RFV-A）以及分叉前视网膜第一静脉处的RFV（RFV-V）。在开始治疗前、每次PRP治疗期间以及PRP治疗后测量血流。

结果

产生的激光光斑总数为4258±461。PRP治疗后6个月，29只（82.85%）眼睛的新生血管活动消退。在第一次、第二次和第三次PRP治疗后，MBR-V显著降低至83.9±16%（p = 0.0039）、79.3±21%（p = 0.0001）和73.5±26%（p = 0.0001）。PRP治疗后1、3和6个月，MBR-V也分别降至75.0±25%（p = 0.0001）、75.0±25%（p = 0.0001）和80.3±22%（p = 0.0001）。在PRP治疗期间及治疗后6个月，RFV-A和RFV-V也显著降低（p<0.01）。