Coscas G, Chaine G
Diabete Metab. 1979 Sep;5(3):247-59.
Laser photocoagulation has changed the visual prognosis of diabetic patients affected by retinopathy. It aims to lower the risk of blindness of diabetic patients. The goal of photocoagulation is to reduce the tissue damage of microangiopathic origin expressed by nonperfusion areas and permeability abnormalities that are responsible for retinal ischemia and oedema respectively. Loss of visual acuity in the diabetic is due mainly to two causes : first, vitreous hemorrhage with its dramatic loss of vision; secondly, macular cystoid oedema, occuring more commonly and with progressive loss of central vision. The efficiency of pan-retinal photocoagulation in reducing the risk of vitreous hemorrhage and consequent blindness in patients with disc or preretinal newly formed vessels, has been ascertained by American and British randomised studies. The indications, technics and results of photocoagulation in non-proliferative diabetic retinopathy are the subject of many studies. Only photocoagulation for macular oedema due to intra-retinal microvascular abnormality has shown to be of benefit.
激光光凝术改变了患有视网膜病变的糖尿病患者的视力预后。其目的是降低糖尿病患者失明的风险。光凝术的目标是减少由无灌注区和通透性异常所表现出的微血管病变源性组织损伤，这些分别是导致视网膜缺血和水肿的原因。糖尿病患者视力丧失主要有两个原因：第一，玻璃体出血导致视力急剧下降；第二，黄斑囊样水肿，更常见且会导致中心视力逐渐丧失。美国和英国的随机研究已证实，全视网膜光凝术在降低患有视盘或视网膜前新生血管的患者发生玻璃体出血及随之而来的失明风险方面的有效性。非增殖性糖尿病视网膜病变光凝术的适应证、技术和结果是许多研究的主题。仅针对视网膜内微血管异常所致黄斑水肿的光凝术已显示出益处。
