全视网膜光凝治疗糖尿病视网膜病变对视野影响的研究进展  

Research progress on the effect of panretinal photocoagulation on visual field in the treatment of diabetic retinopathy

作　　者：张婷 张小猛[1] Zhang Ting;Zhang Xiaomeng(Department of Ophthalmology,the Second Hospital of Jilin University,Changchun 130000,Jilin Province,China)

机构地区：[1]吉林大学第二医院眼科中心,吉林省长春市130000

出　　处：《国际眼科杂志》2024年第7期1093-1097,共5页International Eye Science

摘　　要：糖尿病视网膜病变(DR)早期视野改变往往比视力更能及时反映病情进展。而全视网膜光凝(PRP)治疗DR在延缓病情进展的同时也造成了患眼视力下降和视野缩小等副作用。有研究表明,PRP治疗后的DR患者可因中心20°范围内的视野缺损而导致驾驶测试失败。为保证PRP疗效同时达到降低并发症的目的,激光技术不断改进与发展,通过调整激光参数、使用新型激光系统、与抗血管内皮生长因子(VEGF)药物联合、中西医结合治疗等方式可一定程度改善患眼视野,实现更佳疗效。未来可考虑在缺血指数(ISI)量化分析下,对视网膜缺血程度进行分级,依据ISI指标和视网膜无灌注区分布探索PRP治疗建议的最佳阈值及光凝范围,从而为DR患者提供更及时、更合理的个性化治疗方案。文章就PRP治疗DR对视野的影响进行简要综述。The early change in the visual field in diabetic retinopathy(DR)are often more timely than visual acuity.However,panretinal photocoagulation(PRP)treatment for DR not only delays the progression of the disease,but also causes adverse side effects such as loss of vision and visual field in the affected eye.Studies have shown that patients with DR after PRP treatment may fail a driving test due to visual field defect within a central range of 20°.In order to ensure the efficacy of PRP and achieve the purpose of reducing complications,laser technology has been continuously improved and developed.By adjusting laser parameters,utilizing new laser systems,combining with anti-vascular endothelial growth factor(VEGF)drugs,and integrating traditional Chinese and Western medicine,the visual field in the affected eye can be improved to a certain extent,leading to better treatment outcome.In the future,the degree of retinal ishemia should be quantitatively assessed using the ischemic index(ISI),and the optimal threshold and photocoagulation range of PRP treatment recommendations should be explored based on the ISI index and the distribution of retinal non-perfusion area,so as to provide a more timely and reasonable personalized treatment plan for DR patients.This article briefly reviews the effect of PRP on the visual field in the treatment of DR.

关 键 词：全视网膜激光光凝 糖尿病视网膜病变 视野 抗血管内皮生长因子药物 缺血指数 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]