糖尿病视网膜病变视网膜光凝损伤的临床观察  

Clinical effect of photocoagulation on retinal thickness in eyes with proliferative diabetic retinopathy

作　　者：都晓璐[1] 侯豹可[1] 李莹[1] 姚毅[1] 

机构地区：[1]解放军总医院眼科,北京100853

出　　处：《中华眼外伤职业眼病杂志》2015年第4期269-273,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：基金项目：国家自然科学基金项目（81371032）

摘　　要：目的观察不同波长的氪激光广泛视网膜光凝治疗糖尿病视网膜病变其光斑损伤修复的变化情况。方法前瞻性病例对照研究。选取双眼糖尿病视网膜病变30例（60眼），随机分为氪绿激光组（30右111~）和氪黄激光组（30左眼），分别进行广泛视网膜光凝治疗，并于光凝前、光凝后1h、1周、2周、4周随访，进行光学相干断层扫描（OCT）检查，扫描视盘鼻侧光凝区激光斑的厚度，统计并分析对比两种不同波长的激光对视网膜厚度变化的差异。对同一只眼不同时间点的光斑厚度采用配对样本t检验，对左右眼激光斑的变化情况采用独立样本t检验。结果30例（60眼）分别用氪黄、氪绿激光光凝后，对比激光前后视网膜厚度的变化。激光前后同一只眼视网膜的平均厚度：激光后视网膜水肿，厚度增加8．4％，1周时变薄减少9．5％，2周时减少17．1％，差异均有统计学意义。4周时与2周时相同。比较左右眼同一时间点视网膜厚度的变化，显示其差异无统计学意义。结论氪绿激光和氪黄激光均可以有效治疗糖尿病性视网膜病变，二者对视网膜色素上皮层的损伤效果差异无统计学意义，激光光凝后即时视网膜厚度增加10％左右，2周后视网膜厚度变薄且稳定。Objective To observe the damage and recovecry of panretinal photocoagulation （PRP） by different wavelengths of krypton laser on retina in eyes with proliferative diabetic retinopathy. Methods This was a prospective case-control study of 60 eyes （ 30 right eyes as krypton green laser group and 30 left eyes as krypton yellow laser group） from 30 patients diagnosed as proliferative diabetic retinopathy. They were treated with panretinal photocoagulation （PRP） by a wavelength of 532 nm of krypton green laser and a wavelength of 561 nm of krypton yellow laser respectively. Baseline and morphological changes of optical coherence tomography （OCT） were evaluated before PRP one hour, one week, two weeks, and four weeks after PRP. The thickness of laser spot on nasal optic area was recorded and compared. The thickness of the laser spot of the same eye at different time points were analyzed by using paired sample t-test, while the thickness of the laser spot of the different eyes at the same time point were analyzed by using independent sample t-test. Results Sixty eyes of 30 patients received krypton green laser and krypton yellow laser for PRP respectively. The retinal thickness before PRP was measured as baseline and compared with that at one hour, one week, two weeks, and four weeks after PRP. OCT showed morphological changes of the same eye after PRP： mean retinal thickness was increased by 8.4% at one hour, and dropped as early as one week by 9.5% while 17.1% at two weeks. It remained stable and unchanging at four weeks compared with the data at two weeks. The difference between different time points was statistically significant. No statistically significant difference was found between different eyes at the same time point. Conclusion Krypton green laser and krypton yellow laser all are effective in treating diabetic retinopathy, and there was no statistically significant difference between them in the effect of pigment epithelium layer of retina. The retinal thickness increased by 10% after PRP an

关 键 词：糖尿病视网膜病变 光凝术 激光 氪激光 光学相干断层扫描术 

分 类 号：R587.2[医药卫生—内分泌]