Schimek R A, Spencer R
Arch Ophthalmol. 1979 Jul;97(7):1276-80. doi: 10.1001/archopht.1979.01020020018004.
Severe diabetic retinopathy with neovascular proliferation may produce severe vitreous hemorrhage that prevents laser therapy. Retinal ablation, if indicated, can be partly accomplished by cryopexy. In a small series of cases, cryotherapy to the retina was not apparently harmful and sometimes seemed beneficial. Blood absorption seemed more rapid and recurrent bleeding less frequent; however, vitreous hemorrhages in proliferative diabetic retinopathy are too variable in their natural history of absorption and recurrence to permit any definite conclusion as to the value of this method of retinal ablation. A national collaborative study with lengthy follow-ups will be necessary to determine whether chorioretinal scars produced by laser therapy and those produced by cryotherapy will afford similar protection from the forward course of proliferative diabetic retinopathy, vitreous hemorrhage and blindness. In the meantime, this report is intended to alert ophthalmologists that retinal cryoablation is a conservation alternative to "early" vitrectomy for vitreous hemorrhages from diabetic retinopathy.
伴有新生血管增殖的严重糖尿病性视网膜病变可能会导致严重的玻璃体出血，从而妨碍激光治疗。视网膜消融（如果有指征）可部分通过冷冻疗法完成。在一小系列病例中，对视网膜进行冷冻治疗显然并无害处，有时似乎还有益处。血液吸收似乎更快，复发性出血也较少；然而，增殖性糖尿病性视网膜病变中的玻璃体出血在其自然吸收和复发过程中变化太大，无法就这种视网膜消融方法的价值得出任何明确结论。需要进行一项有长期随访的全国性协作研究，以确定激光治疗产生的脉络膜视网膜瘢痕和冷冻治疗产生的瘢痕是否能为增殖性糖尿病性视网膜病变、玻璃体出血和失明的进展提供类似的保护。与此同时，本报告旨在提醒眼科医生，视网膜冷冻消融是治疗糖尿病性视网膜病变引起的玻璃体出血的一种保守替代“早期”玻璃体切除术的方法。
