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二极管激光(810纳米)与氩绿激光(514纳米)改良格栅光凝治疗弥漫性糖尿病性黄斑水肿的比较

Diode laser (810 nm) versus argon green (514 nm) modified grid photocoagulation for diffuse diabetic macular edema.

作者信息

Akduman L, Olk R J

机构信息

Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, Missouri 63110-1096, USA.

出版信息

Ophthalmology. 1997 Sep;104(9):1433-41. doi: 10.1016/s0161-6420(97)30119-5.

Abstract

OBJECTIVE

To compare argon green (514 nm) versus diode laser (810 nm) modified grid laser photocoagulation treatment in diffuse diabetic macular edema (DDME).

DESIGN

Randomized, prospective clinical trial.

PARTICIPANTS

Patients with DDME and diabetic retinopathy of fewer than two high-risk characteristics in severity, no previous laser photocoagulation for diabetic macular edema, and no other ocular condition that could interfere with assessment of treatment results.

INTERVENTION

One hundred seventy-one eyes of 91 patients were randomized to either argon green (514 nm) or diode laser (810 nm) modified grid laser photocoagulation for DDME. Follow-up was conducted for a minimum of 12 months (16.55 +/- 3.52 months). Retreatment was performed for residual edema involving the foveal avascular zone.

MAIN OUTCOME RESULTS

Visual improvement, visual loss, reduction-elimination of macular edema, and the number of supplemental treatments.

RESULTS

A comparison of visual improvement, visual loss, reduction-elimination of macular edema, and the number of supplemental treatments showed no statistical difference between the groups (P > 0.05 for all groups). Reduction-elimination of DDME was better in the group without cystoid macular edema than the group with cystoid macular edema, but visual outcome appeared to be similar in both groups. History of hypertension or poor initial visual acuity (< or = 20/80) at entry into the study had no significant effect on the outcome. However, the patients without systemic vascular disease have improved more than those with systemic vascular disease regardless of the type of the laser used.

CONCLUSIONS

Diode laser (810 nm) modified grid laser photocoagulation for DDME is equivalent to argon green (514 nm) and patients without systemic vascular disease are more likely to improve after laser treatment with either wavelength.

摘要

目的

比较氩绿(514纳米)与二极管激光(810纳米)改良格栅激光光凝治疗弥漫性糖尿病性黄斑水肿(DDME)的效果。

设计

随机、前瞻性临床试验。

参与者

患有DDME且糖尿病视网膜病变严重程度低于两个高危特征、既往未接受过糖尿病性黄斑水肿激光光凝治疗且无其他可能干扰治疗结果评估的眼部疾病的患者。

干预措施

将91例患者的171只眼随机分为接受氩绿(514纳米)或二极管激光(810纳米)改良格栅激光光凝治疗DDME。随访至少12个月(16.55±3.52个月)。对累及黄斑无血管区的残留水肿进行再次治疗。

主要观察结果

视力改善、视力下降、黄斑水肿减轻或消除以及补充治疗次数。

结果

在视力改善、视力下降、黄斑水肿减轻或消除以及补充治疗次数方面,两组之间无统计学差异(所有组P>0.05)。无黄斑囊样水肿组的DDME减轻或消除情况优于有黄斑囊样水肿组,但两组的视力结果似乎相似。高血压病史或研究入组时初始视力较差(≤20/80)对结果无显著影响。然而,无论使用何种激光类型,无全身性血管疾病的患者比有全身性血管疾病的患者改善更多。

结论

二极管激光(810纳米)改良格栅激光光凝治疗DDME与氩绿(514纳米)等效,且无全身性血管疾病的患者在接受任何一种波长的激光治疗后更有可能改善。

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