短脉冲模式扫描激光治疗糖尿病视网膜病变疗效观察  

Preliminary clinical observation of short-pulse pattern scan laser photocoagulation treatment in diabetic retinopathy

作　　者：吴培培[1] 叶海昀[1] 钟晓菁[1] 田臻[1] 欧杰雄[1] 于珊珊[1] 林婉意[1] 金陈进[1] 

机构地区：[1]中山大学中山眼科中心眼科学国家重点实验室,广州510060

出　　处：《中华眼底病杂志》2014年第2期152-155,共4页Chinese Journal of Ocular Fundus Diseases

基　　金：中山大学临床医学研究5010计划（3030901009045）

摘　　要：目的 观察短脉冲模式扫描激光（PASCAL）系统全视网膜激光光凝（PRP）（PASCAL-PRP）治疗糖尿病视网膜病变（DR）的疗效。方法 临床检查确诊的DR患者43例70只眼纳入研究。其中，男性19例32只眼，女性24例38只眼；年龄45～77岁。视力≥0.1者62只眼，＜0.1者8只眼；伴黄斑水肿者18只眼。严重非增生型DR（NPDR）28只眼，增生型DR（PDR）42只眼。所有患眼均行1次PASCAL-PRP治疗。伴黄斑水肿者应用PASCAL单点模式和黄斑模式（MAC A＋MAC B）。观察治疗后1年患眼视力、视网膜新生血管、黄斑水肿改善情况。结果 70只眼中，视力提高、稳定、下降者分别为10、53、7只眼；黄斑水肿改善、加重、稳定者分别为38、12、20只眼。PDR 42只眼中，视网膜新生血管消退20只眼；视网膜新生血管病灶稳定11只眼；视网膜新生血管病灶活动11只眼。视网膜新生血管病灶活动者，随访期间给予1～2次补充激光光凝治疗。其中因玻璃体积血、出现增生牵拉行玻璃体切割手术治疗3只眼。结论 PASCAL可以选择多种模式治疗DR安全有效。Objective To investigate the clinical outcome and therapeutic efficacy of short-pulse pattern scan laser （PASCAL） photocoagulation for diabetic retinopathy （DR）. Methods Forty-three DR patients （70 eyes） including 19 males （32 eyes） and 24 females （38 eyes） underwent short-pulse PASCAL pan-retinal photocoagulation （PRP）. There were 24 patients （42 eyes） with proliferative diabetic retinopathy （PDR） and 19 patients （28 eyes） with severe nonproliferative diabetic retinopathy （NPDR）. The best corrected visual acuity was better than or equal to 0.1 in 62 eyes, worse than 0.1 in 8 eyes. Diabetic macular edema was found in 18 eyes. Short-pulse PASCAL PRP was applied with multi-spot arrays. Macular edema was treated by PASCAL macular mode （MAC A ＋ MAC B） and/or single spot. Visual acuity and fundus examinations were analyzed at the one-year follow-up procedure. Results One year after short-pulse PASCAL treatment, the final visual acuity was improved in 10 eyes, stable in 53 eyes, decreased in 7 eyes; macular edema was relieved in 38 eyes, aggravated in 12 eyes, and stable in 20 eyes. Of 42 eyes with PDR, neovascularization were regressed in 20 eyes, uncontrolled in 11 eyes which experienced additional photocoagulation （1-2 times） during the follow-up. Among the 11 uncontrolled eyes, 3 eyes（3/11） received vitrectomy due to vitreous hemorrhage. Conclusion PASCAL might stabilize the progress of diabetic retinopathy safely and effectively.

关 键 词：糖尿病视网膜病变 治疗 激光凝固术 

分 类 号：R774.1[医药卫生—眼科] R587.26[医药卫生—临床医学]