Wallow I H, Bindley C D
Department of Ophthalmology, University of Wisconsin-Madison, Madison, Wisconsin.
Retina. 1988;8(4):261-9. doi: 10.1097/00006982-198808040-00008.
This is the first reported clinicopathologic correlation of focal photocoagulation treatment in a diabetic patient treated as part of the Early Treatment of Diabetic Retinopathy Study (ETDRS). Twenty focal argon laser burns were evaluated clinically in their acute and chronic stages, and histopathologically more than 3 years after exposure. Damage profiles of the lesions were reconstructed from serial tissue sections. In single burns the outer nuclear layer defect measured 78 +/- 31 microns, in confluent burns 257 +/- 73 microns. Inner nuclear layer defects were present only in lesions that clinically, during their acute stage, showed a white center or a white collar around the treated target. Fibrous subretinal and subpigment epithelial membranes extended from the burn centers for a distance of up to 900 microns and contained Müller cell processes as identified by immunostaining. These findings confirm the empirical rationale of current focal treatment, but also, because of the apparent risk of membrane formation, urge caution when treating close to the fovea.
这是首次报道的作为糖尿病视网膜病变早期治疗研究（ETDRS）一部分接受治疗的糖尿病患者进行局部光凝治疗的临床病理相关性。对20处氩激光局部烧伤进行了急性和慢性阶段的临床评估，并在暴露后3年多进行了组织病理学评估。从连续组织切片重建病变的损伤情况。单个烧伤的外层核层缺损为78±31微米，融合烧伤为257±73微米。内层核层缺损仅出现在急性期临床上在治疗靶点周围显示白色中心或白色环的病变中。纤维性视网膜下和色素上皮下膜从烧伤中心延伸达900微米，免疫染色显示其中含有 Müller 细胞突起。这些发现证实了当前局部治疗的经验性理论依据，但由于明显存在形成膜的风险，在靠近黄斑中心凹治疗时也需谨慎。
