Sato Y, Kamata A, Matsui M
Department of Ophthalmology, Nihon University School of Medicine, Chiyoda-ku, Japan.
Nippon Ganka Gakkai Zasshi. 1993 Feb;97(2):247-52.
The authors divided 155 eyes (106 cases) affected by pre-proliferative diabetic retinopathy into three sub-groups according to the severity of retinopathy and followed them for one year. The criteria for and numbers of eyes in each group were as follows; 1) mild type with soft exudate and without apparent non-perfused areas on fluorescein angiography (39 eyes). 2) moderate type with soft exudate and demonstrable non-perfused areas (103 eyes). 3) severe type with soft exudates, non-perfused areas and venous beading (13 eyes). The proportion undergoing photocoagulation was 23% in the mild type, 81% in the moderate type and 100% in the severe type. None of the eyes in the mild type underwent photocoagulation unless they advanced to a more severe type. Nine eyes of the mild type which progressed to moderate type during the follow-up period underwent focal photocoagulation. Panretinal photocoagulation was performed in 29% of moderate type eyes and 77% of severe type eyes. The courses of these three sub-groups were analyzed after one year of follow up. The proportion developing proliferative retinopathy was 0% in mild type, 17% in moderate type and 46% in severe type. Based on the above results, we conclude that the sub-classification we propose in this paper can be applied in managing patients with pre-proliferative diabetic retinopathy.
作者将155只受增殖前期糖尿病视网膜病变影响的眼睛(106例)根据视网膜病变的严重程度分为三个亚组,并对其进行了一年的随访。每组的标准和眼睛数量如下:1)轻度类型,有软性渗出物,荧光素血管造影上无明显无灌注区(39只眼)。2)中度类型,有软性渗出物且有可证实的无灌注区(103只眼)。3)重度类型,有软性渗出物、无灌注区和静脉串珠样改变(13只眼)。轻度类型接受光凝治疗的比例为23%,中度类型为81%,重度类型为100%。轻度类型的眼睛除非进展为更严重的类型,否则均未接受光凝治疗。随访期间进展为中度类型的9只轻度类型眼睛接受了局部光凝治疗。中度类型眼睛中有29%、重度类型眼睛中有77%接受了全视网膜光凝治疗。随访一年后分析这三个亚组的病程。轻度类型发展为增殖性视网膜病变的比例为0%,中度类型为17%,重度类型为46%。基于上述结果,我们得出结论,本文提出的亚分类可应用于增殖前期糖尿病视网膜病变患者的管理。