激光诱导脉络膜视网膜静脉吻合术治疗视网膜静脉阻塞  

Laser-induced chorioretinal venous anastomosis for retinal vein occlusion

作　　者：张帆[1] 刘哲丽[1] 

机构地区：[1]中国医科大学附属第一医院眼底病中心,沈阳110001

出　　处：《中华眼底病杂志》2001年第1期8-11,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的　观察激光诱导脉络膜视网膜静脉吻合术治疗视网膜静脉阻塞 (retinal vein occlusion,RVO)的临床疗效。　方法　 RVO患者 2 8例 2 8只眼 ,其中非缺血型组 18例 18只眼 ,采用氪红激光诱导脉络膜视网膜静脉吻合 ;缺血型组 10例 10只眼 ,氪红激光诱导脉络膜视网膜静脉吻合的同时行激光格子样或播散性光凝。术后每 1～ 2周复查 1次视力、眼底 ,术后 2～ 3个月复查荧光素眼底血管造影 (fundusfluorescein angiography,FFA) ,随访 5个月以上。　结果　 18只非缺血型 RVO眼中有 7只眼形成脉络膜视网膜静脉吻合 ,占 38.9% ,7只眼最佳矫正视力提高 (4 .43± 0 .78)行 ,未建立吻合的 11只眼最佳矫正视力降低 (0 .19± 0 .6 7)行 ,二者比较差异有显著性意义 (P<0 .0 0 1)。随访时间内 ,未建立吻合的 11只眼中有4只眼发展为缺血状态 ,占 36 .4%。 10只缺血型 RVO眼中有 2只眼形成脉络膜视网膜静脉吻合 ,占 2 0 .0 % ,视力提高 6行 ;未形成吻合者 ,治疗前后视力没有改变 (P>0 .0 5 )。　结论　激光诱导脉络膜视网膜静脉吻合术是治疗 RVO的一种新的有效疗法 ,尤其适用于非缺血型 RVO患者 ,成功的吻合可防止其发展至缺血状态。Purpose To evaluate the therapeutic effect of laser-induced chorioretinal venous anastomosis for retinal vein occlusion (RVO). Methods The investigation included 28 consecutive patients (28 eyes) with RVO.The non-ischemic group 18 cases (18 eyes) were treated with the krypton red laser to induce chorioretinal venous anastomosis, the ischemic group underwent the same therapy and the grid or scatter-type photocoagulation at the same time. All of the eyes were followed up for more than 5 months, and with an average period of 6.6 months. Results Seven cases (7 eyes, 38.9%) of the non-ischemic group created successful chorioretinal venous anastomosis, with mean improvement of 4.43±0.78 standard deviation (±s)lines of best-corrected visual acuity compared to 0.19±0.67 (±s)lines for 11 eyes with unsuccessful anastomosis (P<0.001). None of the seven eyes developed to ischemic state. Four of the 11 eyes with unsuccessful anastomosis converted to ischemic type (36.4%). Two cases of the ischemic group created successful anastomosis with improvement in visual acuity. The other cases had no change in visual acuity.[WT5”HZ] Conclusion Laser-induced chorioretinal venous anastomosis is a new therapeutic method for RVO, especially for nonischemic type and successful anastomosis can decrease the conversion rate of the vein occlusion to an ischemic state.

关 键 词：视网膜静脉闭塞 眼外科手术 激光凝固术 RVO 

分 类 号：R774.1[医药卫生—眼科] R779.63[医药卫生—临床医学]