对不同分期糖尿病视网膜病变激光光凝治疗的预后分析  

Diabetic Retinopathy at Different Stages with Laser Photocoagulation:a Prognosis Analysis

作　　者：唐柳苹[1] 

机构地区：[1]广西医科大学第五附属医院眼科,柳州市545001

出　　处：《中国激光医学杂志》2009年第3期166-169,共4页Chinese Journal of Laser Medicine & Surgery

摘　　要：目的观察不同分期糖尿病视网膜病变（DR）视网膜激光光凝治疗的预后。方法眼底荧光血管造影（FFA）确诊为增殖前期糖尿病视网膜病变（PPDR）159只眼和增殖期糖尿病视网膜病变（PDR）118只眼,高危PDR75只眼,共180例352眼。根据FFA的检查结果PPDR行次全视网膜光凝、PDR标准全视网膜光凝,高危PDR行超全视网膜光凝。术后3、6和12个月行FFA检查,对新生血管未消退和仍有无灌注区者追加光凝。随访3～24个月。结果PPDR视力有效率92.4%;PDR有效率76.2%;高危PDR有效率69.3%。经一次全视网膜光凝治疗后FFA检查,PPDR有效率93.7%;PDR有效率75.5%;高危PDR有效率65.3%。3～24个月复查FFA,PPDR追加光凝24只眼（15%）,PDR追加光凝42只眼（35.6%）,最终仍有3只眼（2.5%）行玻璃体切割术。高危PDR有50只眼（66.7%）一次或多次追加光凝,仍未能控制病情的12只眼（16.0%）行玻璃体切割术。结论不同分期DR进行视网膜激光光凝的预后不同,及时合理行视网膜光凝术是治疗和改善DR视功能的关键。Objective To observe the effects of panretinal photocoagulation （PRP） for diabetic retinopathy （DR） of different staging and prognosis analysis. Methods The patients with nonprolife rative diabetic retinopathy and proliferative diabetic retinopathy（PDR） were selected and identiffed by fundus fluorescein angiography （FFA）. A total of 352 eyes in 180 eases were received the treatment of subpanretinal （sub- PRP）, standard panretinal （S-PRP） and extra panretinal photocoagulation （E-PRP） respectively according to the result of FFA. The FFA was taken 3, 6 and 12 months after the treatment. For those eases with remaining new vessels and non-perfusion areas, the treatment was complemented with further photocoagulation. The follow-up period was 3-24 months. Results The effective rates in groups of preproliferative DR（PPDR） ,PDR and high risk PDR were 92.4% ,76. 2% and 69. 3% ,respectively. After one time PRP, the effective rates in three groups were 93.7%, 75.5% and 65.5%, respectively. FFA was checked 3-24 months after operation. The number of eyes with further photocoagulation were 24 eyes （15%） ,42 eyes （35.6%） and 50 eyes （66. 7% ） in above three groups, respectively, there were 3 eyes （2.5%） in group of PDR and 12 eyes （ 16. 0% ） in group of high risk PDR to underwent vitreoctomy. Conclusions The prognosis of DR of different staging is different after PDR. It＇s very important to choose reasonable treatment in time for patients with DR to ensure visual acuity maintaining.

关 键 词：激光 视网膜光凝术 糖尿病视网膜病变 

分 类 号：R779.63[医药卫生—眼科] R587.1[医药卫生—临床医学]