糖尿病性视网膜病变个性化视网膜光凝术的临床观察  

Clinical observation of personalized retinal photocoagulation surgery on diabetic retinopathy

作　　者：董如娇[1] 陈芳[1] 赵霞[1] 李冬育 董明霞[1] 

机构地区：[1]唐山市眼科医院,063000

出　　处：《中国实用眼科杂志》2015年第11期1261-1264,共4页Chinese Journal of Practical Ophthalmology

基　　金：唐山市科技局项目（14130260a）

摘　　要：目的观察糖尿病性视网膜病变的个性化视网膜光凝术治疗。方法对2012年3月至2013年6月在唐山市眼科医院就诊的102例增殖前期糖尿病视网膜病（NPDR）变患者170只眼及103例增殖期糖尿病视网膜病变（PDR）患者156只眼，按就诊时间及是否能长期随诊，分为个性化视网膜激光组（个性化PRP组）和常规全视网膜激光组（常规PRP组），观察治疗3个月后复查FFA及矫正视力。结果个性化PRP组与常规PRP组在糖尿病视网膜病变的治疗中同样起作用，差异无统计学意义（P〉0．05）；个性化PRP组较常规PRP组对糖尿病视网膜病变患者的视力影响小，差异有统计学意义（P〈0．05）；对于活跃性糖尿病视网膜病变患者，在可能的情况下先予以行玻璃体腔雷珠单抗注药术，再予以行PRP效果要明显好于单纯PRP，差异有统计学意义（P〈0．05）；结论对于NPDR患者及仅有少量新生血管的PDR患者，可先予以行个性化PRP治疗；对于活跃PDR，先予以行玻璃体腔雷珠单抗注药术后再完成常规PRP是为较好的治疗的选择。Objective To observe the personalized retinal photocoagulation treatment of diabetic retinopathy. Methods One hundred and two cases of patients （170 eyes） with pre-diabetes prolifera- tive retinopathy and 103 cases （156 eyes） with proliferative diabetic retinopathy were randomly di- vided into personalized retina laser group （individualized PRP group） and conventional full- retinal la- ser group （conventional PRP group）, visual acuity and FFA examination was observe 3 months after treatment. Results Personalized PRP group and the conventional group had similar treatment ef- fects, and the difference was not statistically significant. Personalized PRP group had less visual im- pact compared with conventional group, the difference was statistically significant （P〈0.05）. For pa- tients with active diabetic retinopathy it might be better to have vitreous cavity ranibizumab injec- tion first and then the PRP treatment, its effect was significantly better than pure PRP, the differ- ence was statistically significant. Conclusions For patients with NPDR and PDR patients with small amount of new blood vessels can receive personalized PRP therapy first; for active PDR vitre- ous cavity Lucentis injection should be given first and then perform the complete routine PRP is a good choice.

关 键 词：个性化 视网膜光凝术 糖尿病视网膜病变 

分 类 号：R587.2[医药卫生—内分泌]