激光光凝治疗视网膜静脉阻塞的临床价值  

Clinical value of laser photocoagulation in the treatment of retinal vein occlusion

作　　者：熊毅彤[1] 叶纹[1] 孙莉[1] 

机构地区：[1]复旦大学附属华山医院眼科,上海市200040

出　　处：《眼科新进展》2007年第3期210-212,共3页Recent Advances in Ophthalmology

摘　　要：目的评价激光光凝治疗视网膜静脉阻塞的疗效,正确认识激光治疗视网膜静脉阻塞的临床价值。方法随访我院被确诊为视网膜静脉阻塞并经治疗的患者64例65眼,采用病例对照研究方法比较行激光光凝治疗与未行激光光凝治疗2组间的视力预后、眼底改变、Goldman视野改变以及并发症情况。结果经532倍频激光治疗组46例47眼,末次随访视力提高5眼,视力无明显变化29眼,视力下降13眼;非激光治疗组18例18眼,末次随访视力提高2眼,视力无明显变化9眼,视力下降7眼;2组视力预后比较,差异无统计学意义(χ2=0.481,P=0.657>0.05)。2组间视野改变差异无统计学意义(χ2=1.539,P=0.463>0.05)。激光治疗组治疗有效(无新生血管产生或新生血管减少或消退)42眼,非激光治疗组有效7眼,2组疗效比较,差异有显著统计学意义(χ2=13.347,P=0.0003<0.01)。而激光光凝对于黄斑部并发症无明显远期效果,2组间末次随访黄斑部并发症的发生率比较差异无统计学意义(χ2=0.617,P=0.432>0.05)。结论激光光凝治疗不能明确提高中心视力及改善视野,对黄斑部并发症亦无明显远期效果,但能促进水肿、出血、渗出的吸收,对治疗和预防新生血管有明显疗效,对于防止增生性玻璃体视网膜病变和预防继发性新生血管性青光眼可能有效。Objective To evaluate the curative effect of laser photoeoagulation in the treatment of retinal vein occlusion（RVO） ,and to correct realize its clinical value. Methods A total of 64 patients （65 eyes） with RVO diagnosed by fundus fluorescein angiography were investigated in two groups： 46 patients （47 eyes） were treated by frequency-doubled Nd：YAG laser and 18 patients （ 18 eyes） without laser treatmoat. Visual acuity examination, color fundus photography, Goldman visual feld and fimdus fiucrescein angiogtaphy were performed in all cases before and after treatment, and the results were compared. Results The visual acuity with improved,no changed and decreased at the final visit in laser treated group were 5 eyes,29 eyes and 13 eyes respectively,and which in no laser treated group were 2 eyes,9 eyes and 7 eyes respectively,there was no significant difference in statistics between two groups （X^2 =0.481 ,P= 0.657 〉0.05）. There was no significant difference in visual field between taro groups（X^2 = 1.539,P=0.463 〉 0. 05）.There were 42 eyes with effective treatment in laser treated group and in 7 eyes in no laser treated group, there was significant difference between two groups （X^2 = 13, 347 ,P = 0.0003 〈 0.01 ）. But the laser photocoagulation had no long-term effect on the macular complications,the frequency of macular complications at the fi- nal follow up showed no statistically significant difference between two groups（x^2 =0.617,P=0.432 〉0.05）. Conclusion Laser photocoagulation does not increase the visual acuity and improve the visual field, and has no long-term effect on the macular complications,but can promote the absorption of retinal edema,hemorrhage and exudation,has obvious effect on treating .and preventing the neovascularization, and has possible effect on preventing the proliferallve vitreorethaopathy and secondaxy neovascular glaucoma. [ Rec Adv Ophthalmol 2007 ;27 （3） ：210-212 ]

关 键 词：视网膜静脉阻塞 激光光凝 新生血管 

分 类 号：R774[医药卫生—眼科]