Argon激光治疗糖尿病视网膜病变的疗效  

Effect of argon laser photocoagulation on diabetic retinopathy

作　　者：朱承华[1] 卞春及[1] 王飞[1] 刘肖艺[1] 

机构地区：[1]中国南京医科大学附属第一医院眼科,210009

出　　处：《国际眼科杂志》2004年第1期99-103,共5页International Eye Science

摘　　要：目的:探讨Argon激光治疗糖尿病视网膜病变(DR)的疗效和相关影响因素。方法:对1995/2002在我院实施Argon激光治疗糖尿病视网膜病变患者504例(613眼)就疗效和有关影响因素加以回顾性总结与分析。结果:单纯性和增殖性DR视力不变和增进者分别为84%和79%,下降者分别为16%和21%。单纯性DR视力下降以黄斑出血、渗出水肿和晶状体混浊加重为主;增殖性DR视力下降以玻璃体积血、持续黄斑水肿、晶状体混浊加重、新生血管性青光眼和牵引性视网膜脱离为主。伴有高血压、糖尿病性肾病者和Ⅰ型糖尿病患者光凝术后视力下降者居多(33%～85%)。眼底和荧光血管造影随访,单纯性DR83%视网膜水肿、渗出和出血吸收;增殖性DR51%视网膜水肿、渗出和出血吸收,新生血管退缩。16%单纯性DR和34%增殖性DR需要再次补充光凝。结论:DR光凝术应根据眼底和FFA改变确定光凝治疗范围,选择合适波长激光和灵活合理应用各项激光参数,以减少并发症和获得高比例的视网膜有效光斑,同时平稳控制血糖,积极改善患者全身状况,重视光凝术后定期的随访观察,必要时补充光凝。AIM:To inquire into the effect of argon laser photocoagulation on diabetic retinopathy (DR) and its relevant factors.· METHODS: A total of 504 DR cases (613 eyes) treated with photocoagulation in our hospital from 1995 to 2002 were retrospectively studied.· RESULTS: Vision improved or remained unchanged; respectively in 84% of simple DR patients (SDR) and 79% proliferative DR patients (PDR); it decreased respectively in 16% of SDR patients and 21% of PDR patients. Among the SDR patients the main causes reduced vision were exudation, edema and hemorrhage of central fovea of macula and aggravating opacity of lens. The corresponding causes among the PDR patients were vitrous hematocele, persistant edema of macula, increasing opacity of lens, neovascular glaucoma and traction retinal detachment. The patients with hypertension or/and diabetic nephropathy or/and patients of Type I diabetics, produced the highest incidence vision decline after photocoagulation (about 33%-85%). The follow-up of fundus and FFA indicated that 83% SDR patients showed absorption of retinal edema, exudation and bleeding, that 51% PDR patients showed absorption of retinal edema, exudation and bleeding and shrinking of new blood vessels. Sixteen percent SDR patients and 34% PDR patients need to have another photocoagulation.· CONCLUSION: Successful photocoagulation for DR depends on the proper area of photocoagulation according to the fundus and FFA of patients; suitable wavelength of laser is selected and flexible and reasonable parameter of laser reduce complications and to gain effective retinal facula with a higher proportion; the blood sugar must be controlled, the systemic diseases need to be improved; and regular follow-ups must be made and another photocoagulation can be given if necessary.·

关 键 词：Argon激光 治疗 糖尿病视网膜病变 DR 

分 类 号：R779.63[医药卫生—眼科]