Moriarty A P, Spalton D J, Shilling J S, Ffytche T J, Bulsara M
Department of Ophthalmology, St. Thomas's Hospital, London, England.
Ophthalmology. 1996 May;103(5):833-8. doi: 10.1016/s0161-6420(96)30607-6.
Breakdown of the blood-aqueous barrier (BAB) after panretinal photocoagulation (PRP) was measured with a laser flare photometer over a study period of 8 weeks.
Twenty-five eyes of 25 patients who had no previous photocoagulation and required such treatment for proliferative diabetic retinopathy (PDR) were included in the trial. They received 2000 burns (0.1-second exposure, 200 mu m spot) via a panfunduscope and 500 burns (0.1-second exposure, 500-mu m spot) with a Goldmann lens. Power levels were adjusted to produce a mild blanching of the retina. Only an argon green laser (514 nm) was used. Laser photometry was performed on both eyes at 3, 24, 48, 72, 96, and 168 hours and 8 weeks after laser treatment.
Including all of the eyes treated, there was a significant increase in flare value of 3, 24, and 48 hours compared with baseline (Student's t test) but not at 72, 96, and 168 hours or at 8 weeks. Peak values occurred at 24 hours. When blue and brown irides were analyzed separately, there was a significant increase in flare for blue irides compared with baseline levels at 3 and 24 hours, whereas for brown irides the increased flare was sustained at 3, 24, 48, 72, and 96 hours (Student's paired t test). In addition, when the increase in flare value from baseline was compared between blue and brown irides (pooled Student's test), there was a sustained increase at 24, 48, 72, and 96 hours for brown irides compared with blue. Clinically significant uveitis, posterior synechiae, or peripheral anterior synechiae did not develop in any of the patients.
Breakdown of the BAB may occur after PRP, particularly in more heavily pigmented irides. The time course of this suggests that the phenomenon is related directly to laser effects in the anterior segment, although other factors may contribute.
在8周的研究期间，使用激光 flare 光度计测量了全视网膜光凝（PRP）后血-房水屏障（BAB）的破坏情况。
该试验纳入了25例此前未接受过光凝治疗且因增殖性糖尿病视网膜病变（PDR）需要进行此类治疗的患者的25只眼。他们通过全眼底镜接受了2000次烧灼（0.1秒曝光，200微米光斑），并使用戈德曼透镜进行了500次烧灼（0.1秒曝光，500微米光斑）。调整功率水平以产生视网膜轻度变白。仅使用氩绿激光（514纳米）。在激光治疗后3、24、48、72、96和168小时以及8周时对双眼进行激光光度测量。
包括所有接受治疗的眼睛，与基线相比，3、24和48小时时flare值显著增加（Student t检验），但在72、96和168小时以及8周时未增加。峰值出现在24小时。当分别分析蓝色和棕色虹膜时，蓝色虹膜在3和24小时时与基线水平相比flare显著增加，而对于棕色虹膜，flare增加在3、24、48、72和96小时持续存在（Student配对t检验）。此外，当比较蓝色和棕色虹膜从基线开始的flare值增加时（合并Student检验），与蓝色虹膜相比，棕色虹膜在24、48、72和96小时持续增加。所有患者均未发生具有临床意义的葡萄膜炎、后粘连或周边前粘连。
PRP后可能发生BAB破坏，尤其是在色素沉着较重的虹膜中。这一现象的时间进程表明，该现象与眼前节的激光效应直接相关，尽管可能还有其他因素起作用。
