未累及黄斑区的缺血型视网膜分支静脉阻塞眼底激光治疗前后对比敏感度的变化  

Analysis of contrast sensitivity before and after fundus laser treatment for ischemic branch retinal vein occlusion without involving macular region

作　　者：王志学[1] 王文英[1] 曹婷婷[1] 

机构地区：[1]河北省沧州市中心医院眼科,河北沧州061001

出　　处：《中国现代医学杂志》2017年第22期78-83,共6页China Journal of Modern Medicine

摘　　要：目的观察未累及黄斑区的缺血型视网膜分支静脉阻塞(BRVO)患者眼底激光治疗前后对比敏感度(CS)的变化情况。方法收集38眼未累及黄斑区的缺血型BRVO患者进行眼底激光治疗,并观察3个月,分别测试激光治疗前及治疗后1和3个月的矫正视力及空间频率为1.5、3、6、12、18周/度(c/d)处的CS。CS两组间的比较采用两独立样本t检验,CS及矫正视力的多组间比较采用单因素方差分析,组间多重比较方差齐性时采用LSD检验,方差不齐性时采用Dunnett’s T3检验。结果所有患者激光治疗后3个月通过眼底荧光血管造影(FFA)检查证实显效的20眼(52.63%),有效13眼(34.21%),无效的5眼(13.16%),总共治疗有效33眼(86.84%)。所有患者激光治疗前及激光治疗后1和3个月与对照组比较,差异有统计学意义(P<0.05),各空间频率下的CS降低。激光治疗后1个月与激光治疗前比较,差异有统计学意义(P<0.05),各空间频率CS降低。激光治疗后3个月与激光治疗前及激光治疗后1个月在12c/d、18c/d空间频率下比较,差异有统计学意义(P<0.05)。激光治疗后CS降低值在患者性别及年龄分组比较,差异无统计学意义(P>0.05)。将BRVO按阻塞部位、范围及非灌注区面积分组比较激光治疗后CS降低值,差异有统计学意义(P<0.05),显示阻塞部位在颞侧及阻塞范围较大、非灌注区面积较大的患者在激光治疗后在高频区(12c/d、18c/d)CS降低较多。随访3个月,BRVO患者激光治疗后与未进行激光治疗的患者比较,差异有统计学意义(P<0.05),各空间频率下的CS降低,特别是12c/d、18c/d空间频率下CS降低明显。结论眼底激光治疗是治疗缺血型BRVO的有效方法,但是激光治疗对于患者视网膜功能也是一种损伤,可造成未累及黄斑区的缺血型BRVO患者CS下降,尤其是高频区CS。Objective To observe the change of contrast sensitivity(CS) before and after fundus laser treatment for ischemic branch retinal vein occlusion(BRVO) without involving the macular region. Methods Thirty-eight eyes with ischemic BRVO without involving the macular region received fundus laser treatment and were observed for 3 months. The CS with the spatial frequency of 1.5, 3, 6, 12 and 18 weeks/degree(c/d) and the corrected visual acuity were tested before and 1 and 3 months after laser treatment. The CS in the two groups was compared with two independent samples t-test. The CS and the corrected vision were compared among multiple groups using the analysis of variance(ANOVA), and compared between two groups using LSD test in case of homogeneity of variance but using Dunnett's T3 test in case of nonhomogeneity of variance. Results Confirmed by FFA 3 months after treatment, laser treatment was markedly effective for 20 of 38 eyes(52.63%), effective for 13 eyes(34.21%), and ineffective for 5 eyes(13.16%); the total effective rate was 86.84%(33/38). Before treatment and 1 and 3 months after laser treatment, the CS at each spatial frequency decreased in all patients compared with the control group with statistical differences(P < 0.05). The CS at each spatial frequency decreased 1 month after laser treatment compared with that before treatment, the differences were statistically significant(P < 0.05). The CS at the spatial frequency of12 c/d and 18 c/d decreased 3 months after laser treatment compared with that before treatment and 1 month after laser treatment with statistical differences(P < 0.05). After laser treatment, there were no significant differences in the CS reduction among different gender or age groups. Grouping BRVO according to obstruction location, range and non-perfusion area, the CS reduced, the reduction was more obvious at high frequency(12 c/d and 18 c/d) in the patients with obstruction on the temporal side, a larger blocking range or a larger non-perfusion area, the differences were statisticall

关 键 词：视网膜分支静脉阻塞 对比敏感度 眼底激光 视力 

分 类 号：R774.1[医药卫生—眼科]