多点扫描矩阵激光与氪黄激光治疗糖尿病性视网膜病变的对比研究  

Comparison of supra scan and krypton yellow laser photocoagulation in treatment of diabetic retinopathy

作　　者：田璐[1] 徐延山[1] 路露[2] 

机构地区：[1]天津医科大学眼科临床学院,天津市眼科医院,天津市眼科学与视觉科学重点实验室,天津市眼科研究所,天津300020 [2]沧州眼科医院,河北061001

出　　处：《中国实用眼科杂志》2012年第9期1040-1044,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的应用光学相干断层扫描（optical coherence tomography，OCT）联合多焦视网膜电图（multifocal eleetroretinogram，mfERG）观察多点扫描矩阵激光全视网膜光凝治疗重度非增殖性糖尿病视网膜病变（severenon—proliferative diabetic retinopathy，severeNPDR）及增殖性糖尿病视网膜病变（proliferative diabetic retinopathy，PDR）后激光对视网膜组织结构及视网膜功能的影响。方法临床病例对照研究。对2010年4-11月在天津市眼科医院就诊的53例（64只眼）DR患者随机分为多点扫描矩阵激光（实验组）；传统多波长氪黄激光组（对照组）。随访时间3个月，光凝前进行最佳矫正视力（thebestcorrectedvisualacuity，BCVA）、裂隙灯生物显微镜、眼底、眼底荧光血管造影（fudusfluoresceinangiography，FFA）、OCT及mfERG检查，术后1周、1月、3月进行BCVA、OCT及mfERG检查。比较两组异同，，结果激光术后两组黄斑中心凹厚度均m现明显增加，但两组差异无统计学意义（F值=20．722和23．752，P〉0．05）。两组P1波、N1波振幅密度均出现不同程度下降，术后1周下降最冠著，术后1～3月逐渐恢复，术后对照组各波振幅密度下降幅度较实验组明显且恢复速度慢。结论本研究证实多点扫描矩阵激光与氪黄激光在治疗糖尿病视网膜病变上疗效相同，并对视网膜功能损伤较小。Objective To investigate the effects of pan-retinal photocoagulation （PRP） with supra scan laser on the severe non-proliferative diabetic retinopathy and to analyze the affect of retinal struc- ture and function after laser photocoagulation by optical coherence tomography （OCT） and multifocal electroretinogram （mfERG）. Methods Sixty-four eyes of 53 severe non-proliferative diabetic retinopa- thy patients were assigned randomly to receive either supra scan laser or krypton yellow laser treat- ment. Follow up examinations were performed 3 months, the best corrected visual acuity （BCVA）, slit-lamp biomicroscopy, ophthalmoscopy, fudus ftuorescein angiography （FFA）, OCT and mfERG were performed before treatment. One week, 1 month, 3 months after treatment, BCVA, OCT and mfERG were examined. The differences between two groups were compared. Results The central subfield thick- ness increased in both groups after treatment, there was especially obvious increase in the control group,there was no statistical difference in both group （P 〉0.05）,the P1,Nl waves amplitude had vari- ous loss and reached the lowest level at l week after treatment and recovered gradually from 1 month to 3 months aiter treatment, the amplitude of control group decreased more significantly and recovered more slowly compared to the test group.. Conclusions Supra scan laser photocoagulation for DR is as effective as krypton yellow laser,and reduces the damage at the same time.

关 键 词：糖尿病性视网膜病变 激光治疗 光学相干断层扫描 多焦视网膜电图 

分 类 号：R587.2[医药卫生—内分泌]