Koerner F, Fries K, Niesel P, Dubied P
Klin Monbl Augenheilkd. 1978 Apr;172(4):440-4.
A preliminary report is given on studies of the retinal circulation in diabetic retinopathy before and after photocoagulation treatment. The local retinal circulation time RCT of selected retinal areas was calculated by means of a fluorescein long-term infusion technique. In 7 eyes with diabetic retinopathy (DR) the mean RCT was significantly higher (2.0 +/- 0.58 sec. range 1.27-2.6) than in 15 control eyes (1.11 +/- 0.34 sec, range 0.50-1.82, Niesel 1976). Assuming an increase of blood flow in DR (L'Esperance 1971, Kohner 1975) the increase of RCT by a factor 2 would imply an increase of the vascular volume by a factor hardly less than 3 indicating the marked impairment of retinal hemodynamics in DR. After photocoagulation, the mean RCT was significantly shortened only in eyes with preoperative RCT values above 2 sec. The reduction of local RCT correlated with the extent of treated retinal areas. The cross-sectional area of the retinal veins measured near the optic disc was generally reduced independently of the extent of coagulation treatment. Taking also the obvious postoperative reduction of the total retinal vascular volume into account, photocoagulation resulted in a marked decrease of blood flow not only in extensively treated but also in areas with little coagulation effects. In DR the disturbed retinal circulation in general tends to normalize following extensive photocoagulation.
给出了关于糖尿病性视网膜病变光凝治疗前后视网膜循环研究的初步报告。通过荧光素长期输注技术计算选定视网膜区域的局部视网膜循环时间(RCT)。7只患有糖尿病性视网膜病变(DR)的眼睛的平均RCT(2.0±0.58秒,范围1.27 - 2.6)显著高于15只对照眼睛(1.11±0.34秒,范围0.50 - 1.82,尼塞尔,1976)。假设DR中血流量增加(莱埃斯佩兰斯,1971;科纳,1975),RCT增加两倍意味着血管容积增加至少三倍,表明DR中视网膜血液动力学明显受损。光凝治疗后,仅术前RCT值高于2秒的眼睛平均RCT显著缩短。局部RCT的降低与治疗的视网膜区域范围相关。在视盘附近测量的视网膜静脉横截面积通常会减小,与光凝治疗范围无关。同时考虑到术后视网膜总血管容积明显减少,光凝不仅导致广泛治疗区域血流量显著减少,而且导致光凝效果较小区域的血流量也显著减少。在DR中,广泛光凝后,通常紊乱的视网膜循环趋于正常化。