Kaufman S C, Ferris F L, Seigel D G, Davis M D, DeMets D L
Biometry and Epidemiology Program, National Eye Institute, Bethesda, Maryland 20892.
Invest Ophthalmol Vis Sci. 1989 Jan;30(1):23-8.
Six risk factors for severe visual loss despite panretinal (scatter) photocoagulation were identified by analyzing data collected during the first 5 years after randomization in the Diabetic Retinopathy Study. Proportional hazards regression revealed NVD (neovascularization on/around the optic disc) to be the most important risk factor. The risk of severe visual loss rose with increasing NVD, hemorrhages/microaneurysms, retinal elevation, proteinuria, and hyperglycemia and fell with increasing "treatment density." These results are similar to previous DRS findings on untreated eyes. The importance of "treatment density" as an independent predictor of visual outcome is a new finding and lends support to the common clinical practice of repeating photocoagulation if initial treatment does not reduce or stabilize retinal neovascularization.
通过分析糖尿病视网膜病变研究随机分组后前5年收集的数据，确定了尽管进行了全视网膜（散射）光凝仍导致严重视力丧失的六个风险因素。比例风险回归显示视盘上/周围新生血管（NVD）是最重要的风险因素。严重视力丧失的风险随着NVD、出血/微动脉瘤、视网膜隆起、蛋白尿和高血糖的增加而上升，随着“治疗密度”的增加而下降。这些结果与糖尿病视网膜病变研究之前关于未治疗眼睛的发现相似。“治疗密度”作为视力结果独立预测因素的重要性是一项新发现，为初始治疗未能减少或稳定视网膜新生血管时重复进行光凝的常见临床实践提供了支持。
