激光诱导脉络膜视网膜静脉吻合术对非缺血型视网膜静脉阻塞所致黄斑水肿的疗效观察  

The therapeutic efficacy of laser-induced chorioretinal venous anastomosis on macular edema of non-ischemic retinal vein occlusion

作　　者：刘哲丽[1] 温晓霞[1] 张帆[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》2002年第1期10-12,共3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非缺血型视网膜静脉阻塞 (retinal vein oc-clusion,RVO)所致黄斑水肿的疗效。　方法　非缺血型 RVO患者 37例 37只黄斑水肿眼均使用氪红激光诱导脉络膜视网膜静脉吻合 ,吻合术后随访 6～ 12个月 (平均随访 9个月 ) ,对比分析建立和未建立脉络膜视网膜静脉吻合的眼治疗前后视力、眼底、荧光素眼底血管造影 (fundus fluorescein angoigraphy,FFA)、中心5°视网膜光敏感度的改变。　结果　 37只眼中 ,激光治疗后 2个月内有 18只眼建立脉络膜视网膜静脉吻合 ,成功率 4 8.6 %。建立与未建立脉络膜视网膜静脉吻合的眼 ,治疗前后平均最佳矫正视力差异有显著性意义(P<0 .0 0 1)。建立吻合的眼 ,中心 5°光敏感度与治疗前相比有明显提高 (t=2 .910 ,P<0 .0 0 5 ) ;FFA显示 16只眼黄斑水肿消失或减轻 ,2只眼黄斑囊样水肿仍存在。未建立吻合的眼 ,中心 5°光敏感度与治疗前相比有所下降 (t=1.92 8,P<0 .0 5 ) ,FFA显示黄斑水肿加重。　结论　 RVO所致黄斑水肿未发展至囊样变性之前 ,激光诱导建立脉络膜视网膜静脉吻合可使 RVO所致黄斑水肿消退或减轻 。Objective To evaluate the therapeutic effect of laser induced chorioretinal venous anastomosis on macular edema of non ischemic retinal vein occlusion. Methods Thirty seven eyes of 37 cases of non ischemic retinal vein occlusion received the treatment of laser induced chorioretinal venous anastomosis and were followed up for 6～12 months. All affected eyes underwent the clinical examinations of visual acuity, ocular fundus photography, fundus fluoreceine angoigraphy (FFA) and light sensitivity of central 5 degree of the retina, and the pre and post operative clinical materials were analyzed. Results Successful chorioretinal venous anastomosis was formed in 18 eyes (48.6%) within 2 months after laser photocoaglation, with the mean best improved corrected visual acuity of (4 25±0 46) lines, while the mean best corrected visual acuity of the other 19 eyes with unsuccessful anastomosis decreased (0 20±0 54) lines ( P <0 001). The light sensitivity of central 5 degree of the 18 eyes with successful anastomosis improved ( P <0 001), with resolution of macular edema in 16 eyes, although cystoid macular edema in 2 eyes remained no change. The light sensitivity of central 5 degree of the 19 eyes with unsuccessful anastomosis have decreased ( P <0 05), with aggrevation of the macular edema. Conclusion Successful laser induced chorioretinal anastomosis can resolute the macular edema caused by retinal vein occlusion, especially for diffused macular edema caused by early retinal vein occlusion.

关 键 词：黄斑水肿 脉络膜视网膜静脉吻合术 激光诱导 非缺血型视网膜静脉阻塞 

分 类 号：R779.63[医药卫生—眼科]