577 nm激光多点与单点扫描模式全视网膜激光光凝治疗非增生期糖尿病视网膜病变疗效比较  

Comparison of the efficacy of multi-point or single-point mode of 577 nm laser in the treatment of diabetic retinopathy

作　　者：张茉莉[1] 田蓓[1] 魏文斌[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科研究所北京市眼科学与视觉科学重点实验室,100730

出　　处：《中华眼底病杂志》2015年第1期36-40,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：国家自然科学基金（81272981）;北京市自然科学基金（7112031）;北京市卫生系统高层次卫生技术人才培养计划项目（2009-3-32）

摘　　要：目的 比较577 nm激光多点扫描一次完成全视网膜激光光凝（PRP）与单点多次完成PRP治疗非增生期糖尿病视网膜病变（NPDR）的临床效果.方法 前瞻性对照研究.临床确诊为重度NPDR的29例患者46只眼纳入研究.将其随机分为多点扫描组和单点模式组,分别为12例22只眼和17例24只眼.多点扫描组采用多点扫描模式,一次完成RPR.单点模式组采用单点模式,分3～4次完成RPR.治疗前1d及治疗后1d,1、2、6、12个月检测患眼最佳矫正视力,以此评判其治疗有效率;同时观察两组患眼治疗前后30°～60°环形范围内视野平均阈值敏感度,闪光视网膜电流图（F-ERG）a、b波振幅,以及荧光素眼底血管造影（FFA）的变化情况.对比观察两种激光扫描模式PRP的治疗效果以及两组的激光能量、光斑数量,并计算激光能量密度.结果 多点扫描组和单点模式组治疗有效率分别为86.4％、79.2％;两组治疗有效率比较,差异无统计学意义（χ^2=0.414,P＞0.05）.治疗后1d,多点扫描组和单点模式组30°～60°环形范围内视野平均阈值敏感度及F-ERG a、b波振幅均较治疗前1d降低,差异均有统计学意义（P＜0.05）.治疗后2、6、12个月,多点扫描组和单点模式组视野平均阈值敏感度及F-ERG a、b波振幅提高程度比较,差异均无统计学意义（P＞0.05）.多点扫描组和单点模式组平均激光能量分别为（537.50±64.69）、（339.09±132.09） mW,平均光斑数分别为（1934.32±426.38）、（2061.42±375.49）点,平均能量密度分别为（0.35±0.12）、（1.95±0.86） mW·ms/μm^2.两组激光能量及能量密度比较,差异均有统计学意义（P＜0.05）;光斑数量比较,差异无统计学意义（P＞0.05）.结论 577 nm激光多点扫描一次完成PRP与单点多次完成PRP治疗重度NPDR的效果相当;但多点扫描模式能量密度低,激光损伤较小.Objective To compare the therapeutic effects of 577 nm laser panretinal photocoagulation （PRP） between one time multi-point scanning mode and multiple time single-point mode in the treatment of eyes with non-proliferative diabetic retinopathy （NPDR）.Methods This is a prospective controlled study from August 2013 to February 2014.A total of 29 patients （46 eyes） with clinically diagnosed severe NPDR were randomly divided into two groups including the treatment group （12 patients,22 eyes） and the control group （17 patients,224 eyes）.The treatment group received one time PRP of multi-point scanning mode,and the control group received 3-4 times of PRP with single-point mode.In order to evaluate its efficacy,the best corrected visual acuity was measured before treatment,and 1 day,1,2,6 and 12 months after treatment.The average threshold sensitivity,a/b-wave amplitude of flash ERG （F-ERG） in the 30 °-60 ° visual field,and fundus fluorescein angiography （FFA） of the change were also compared between the 2 groups.The laser energy and the number of laser spots were compared,and the laser energy density was calculated.Results The response rate was 86.4% and 79.2%,respectively in the treatment and control group,the difference was not statistically significant （χ^2=0.414,P〉0.05）.Compare to the pre-treatment measurement,the average threshold sensitivity,a/b-wave amplitude of F-ERG in the 30 °-60 ° visual field were reduced at 1 day after treatment both in treatment and control group,the differences were statistically significant （P〈0.05）.The average threshold sensitivity,a/b-wave amplitude of F-ERG were no difference between treatment and control group at 2m,6m and 12m after treatment （P〉0.05）.The average laser power,number of laser spots and energy density were （537.50 ± 64.69） mW and （339.09 ± 132.09） mW,（1934.32 ± 426.38） points and （2061.42 ± 375.49） points,（0.35±0.12） mW o ms/μm^2 and （1.95 ± 0.86） mW · ms/μm2 in the treatment group and t

关 键 词：糖尿病视网膜病变/治疗 激光凝固术/方法 激光凝固术/利用 

分 类 号：R774.1[医药卫生—眼科]