561 nm与532 nm激光光凝治疗重度非增生性糖尿病视网膜病变的临床疗效比较  

Comparison of the clinical effects of 561 nm and 532 nm laser photocoagulations on treatment of severe non-proliferative diabetic retinopathy

作　　者：段娜[1] 李加青[2] 陈梦平[3] 廖锐[1] DUAN Na;LI Jia-qing;CHEN Meng-ping(Department of Ophthalmology,Huizhou Third People′s Hospital,Guangdong 516002,China)

机构地区：[1]惠州市第三人民医院眼科,广东516002 [2]中山大学中山眼科中心,广州510000 [3]郑州市第二人民医院眼科,河南450000

出　　处：《中国临床新医学》2023年第6期608-613,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：惠州市科技计划项目资助课题(编号:2021WC0106160)。

摘　　要：目的比较561 nm、532 nm激光光凝治疗重度非增生性糖尿病视网膜病变(NPDR)的临床疗效。方法招募2021年6月至2022年8月惠州市第三人民医院收治的重度NPDR不合并黄斑水肿的患者46例(82眼),均行全视网膜激光光凝(PRP)治疗。采用随机数字表法将其分为观察组(23例,42眼)和对照组(23例,40眼)。观察组和对照组激光光凝治疗波长分别为561 nm和532 nm。比较两组治疗前,以及治疗后2周、1个月、3个月、6个月的最佳矫正视力(BCVA)、中央黄斑厚度(CMT)、视网膜神经纤维层(RNFL)厚度。比较两组不良反应发生情况。结果治疗后两组BCVA较治疗前显著提高(P<0.05),但两组各时间点BCVA比较差异无统计学意义(P>0.05)。治疗后,两组患眼CMT、RNFL厚度均呈下降趋势(P<0.05),且观察组在治疗后2周、1个月、3个月、6个月的CMT较对照组薄,RNFL厚度较对照组厚,差异有统计学意义(P<0.05)。治疗后两组继发黄斑水肿、玻璃体积血和新生血管性青光眼发生率比较差异无统计学意义(P>0.05)。结论561 nm激光光凝治疗重度NPDR安全、有效,对CMT及RNFL厚度影响较532 nm激光小,有利于保存视功能。Objective To compare the clinical effects of 561 nm and 532 nm laser photocoagulations on treatment of severe non-proliferative diabetic retinopathy(NPDR).Methods Forty-six patients(82 eyes)with severe NPDR without macular edema who were admitted to Huizhou Third People′s Hospital from June 2021 to August 2022 were recruited.All of them were treated with panretinal photocoagulation(PRP).The patients were divided into observation group(23 cases,42 eyes)and control group(23 cases,40 eyes)by random number table method.The treatment wavelength of laser photocoagulation was 561 nm in the observation group and 532 nm in the control group.The best corrected visual acuity(BCVA),central macular thickness(CMT)and retinal nerve fibre layer(RNFL)thickness were compared between the two groups before treatment and 2 weeks,1 month,3 months and 6 months after treatment.The occurrence of adverse reactions was compared between the two groups.Results After treatment,the values of BCVA in the two groups were significantly increased compared with those before treatment(P<0.05),but there was no significant difference in BCVA at each time point between the two groups(P>0.05).After treatment,the thicknesses of CMT and RNFL showed a downward trend in the affected eyes in both groups(P<0.05),and the thicknesses of CMT in the observation group were lower than those in the control group 2 weeks,1 month,3 months and 6 months after treatment,and the thicknesses of RNFL in the observation group were higher than those in the control group,with statistically significant differences between the two groups(P<0.05).There were no significant differences in the incidence rates of secondary macular edema,vitreous hematoma and neovascular glaucoma between the two groups after treatment(P>0.05).Conclusion In the treatment of severe NPDR,561 nm laser photocoagulation is safe and effective,and has less effects on the thicknesses of CMT and RNFL than 532 nm laser,which is beneficial to the preservation of visual function.

关 键 词：非增生性糖尿病视网膜病变 全视网膜激光光凝 中央黄斑厚度 视网膜神经纤维层 

分 类 号：R774.1[医药卫生—眼科]