激光诱导脉络膜视网膜静脉吻合术治疗实验性视网膜分支静脉阻塞的激光能量选择  

Optimal laser energy for laser induced chorioretinal venous anastomosis in the treatment of experimental branch retinal vein occlusion

作　　者：张含[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》2002年第1期13-16,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的　观察不同激光能量诱导脉络膜视网膜静脉吻合 (laser induced chorioretinal venousanastomosis)治疗实验性视网膜分支静脉阻塞 (branch retina vein occlusion,BRVO)的成功率和组织学损伤情况 ,以确定最佳的激光治疗能量。　方法　 4 0只有色家兔的 80只眼随机分为 4组 ,每组 10只兔 2 0只眼 ,采用光动力方法建立 BRVO模型 ,2 4 h后以 5 0 μm光斑、0 .1s的红色氪离子激光的不同能量 (A组4 0 0 m W、B组 6 0 0 m W、C组 80 0 m W和 D组 10 0 0 m W)诱导脉络膜视网膜静脉间的吻合 ,在实验后第 1、2、4、6、8周时进行眼底照相和荧光素眼底血管造影检查 ,并在实验结束时 (施行静脉吻合术后第 8周末 )摘除眼球进行组织学检查。　结果　 80只兔眼均成功建立了 BRVO模型。A组无一例诱导脉络膜视网膜静脉吻合成功 ,激光对周围视网膜、脉络膜的损伤最轻 ,Bruch膜基本完整 ;B、C组诱导成功率分别为 15 %和5 5 % ,激光对周围组织的损伤中等 ;D组诱导成功率为 80 % ,激光对周围组织的损伤最重。 4组之间比较 ,诱导成功率差异有非常显著性意义 (P=0 .0 0 1) ;其中 C组诱导静脉吻合成功率明显高于 B组 (PBC=0 .0 0 8) ;A组和 B组、C组和 D组之间比较 ,成功率的差异没有显著意义 (PAB=0 .0 72、PCD=0 .0 91)。Objective To inspect the rate of success of anastomosis and tissue damage with different power levels of photocoagulation in the treatment of experimental branch retinal vein occlusion (BRVO) by laser induced chorioretinal venous anastomosis. Methods Forty pigmented rabbits (80 eyes) were divided into four groups in random, and 10 (20 eyes) in each. Chroioretinal venous anastomosis was attempted to create using the krypton red laser with 4 different power levels (group A: 400 mW,group B: 600 mW,group C: 800 mW,group D: 1000 mW) in these animals in which BRVO had previously been created photodynamically. Fundus photography and fundus fluorescein angiography were performed at various times after the treatment and histological examination was taken at the end of the study. Results The model of BRVO was successfully set up. At the lowest power of 400 mW there was an absence of anastomosis formation and the damage to the retina and choroid was mild, Bruch′s membrane showed no evidence of rupture. At the power levels of 600 mW and 800 mW an anastomosis formed in 15% and 55% respectively and the damage was medium in degree. At the highest power level of 1 000 mW a 80% rate of success was obtained, however, the damage to the retina and choroid tended to be severe. The difference of the rate of success of anastomosis between different groups was highly significant ( P =0 001), the difference between group B and group C was also highly significant ( P BC =0.008), and the difference between group A and group B, group C and group D was not significant ( P AB =0 072、 P CD =0 091). Conclusion The optimal power level of krypton red laser induced chorioretinal venous anastomosis is 800 mW, 0.1 s, 50 μm in our study.

关 键 词：视网膜静脉闭塞 脉络膜视网膜静脉吻合术 激光诱导 动物模型 激光能量 眼底血管疾病 

分 类 号：R779.63[医药卫生—眼科]