摘要
目的通过自行设计的计算机软件量化激光斑面积,计算糖尿病视网膜病变(diabetic retinopathy,DR)患者全视网膜光凝(panretinal photocoagulation,PRP)后激光斑所占眼底图总面积百分比,探讨激光斑面积与视力及黄斑厚度、黄斑容积之间的关系。方法选择重度非增生性DR患者30例60眼行PRP治疗。将不伴有黄斑水肿的患者分为A、B两组,每组24眼;将伴有黄斑水肿的患者分为C、D两组,每组6眼。其中A、B两组行PRP,C、D两组先行黄斑格栅样光凝,1周后再行PRP;A组、C组PRP间隔1个激光斑;B组、D组PRP间隔2个激光斑。记录PRP前、PRP后3个月各组视力及黄斑厚度、黄斑容积,并测量4组眼底激光斑面积占眼底图总面积的百分比,比较激光斑面积比值与激光治疗效果的关系。结果 PRP间隔1个激光斑时,激光斑面积(像素)为20000～50000(34398.27±8808.51),激光斑面积与眼底图总面积的百分比为(32.64±4.43)%(25%～40%)。PRP间隔2个激光斑时,激光斑面积为10000～20000(15442.33±2737.77),激光斑面积与眼底图总面积的百分比为(18.35±3.43)%(10%～25%)。A组与B组比较,PRP后视力、黄斑厚度及黄斑容积差异均无统计学意义(均为P>0.05);C组与D组比较,PRP后视力恢复更好,黄斑厚度及黄斑容积均有显著降低(均为P<0.05)。结论有效的激光斑面积是PRP治疗成功的关键,对于伴有黄斑水肿的重度非增生性DR患者,激光斑所占视网膜总面积为25%～40%时,术后视力及黄斑厚度、黄斑容积恢复较好。
Objective To calculate the percentage of retinal areas after panretinal photocoagulation（ PRP） by ourselves developed software,and explore the association between the laser spot area with visual acuity（ VA） ,macular thickness and macular volume in patients with diabetic retinopathy （ DR） .Methods Thirty patients （ 60 eyes） with server non-proliferation DR were selected.Those without ME were divided into group A （ 24 eyes） and group B （ 24 eyes） ,and those with ME divided into group C （ 6 eyes） and group D （ 6 eyes） .Group A and Group B were treated with PRP.Group C and D were first treated with macular grid photocoagulation,then treated with PRP 1 week later.Group A and group C were treated with a distance of 1 laser spot between every two laser spots,while group B and group D with a distance of 2 laser spot.The macular thickness, macular volume and VA of each group at 3 months before and after PRP were recorded, and the percentage of the laser spot area in the whole area of eye ground was measured, then association between the laser spot area ratio and the effect of laser treatment was explored.Results The laser spot size （ pixel） ranged from 20 000 to 50 000 （ 34 398.27±8808.51） and the laser spot area ratio was from 25% to 40% （ 32.64±4.43） % when the interval was one laser spot distance.The laser spot size ranged from 10 000 to 20 000 （ 15 442.33±2737.77） and the laser spot area ratio was from 10% to 25% （ 18.35±3.43） % when the interval was two laser spots distance.There was no significant difference between VA,macular thickness and macular volume of group A and group B after PRP（ all P 0.05） ,while there were significant differences between VA,macular thickness and macular volume between group C and group D（ all P 0.05） .Conclusion Effective laser spot area is the key to a successful treatment for PRP.VA,macular thickness and macular volume improve best when the laser spot area ratio is from 25% to 40%.
出处
《眼科新进展》
CAS
北大核心
2013年第2期165-168,共4页
Recent Advances in Ophthalmology
作者简介
李朝晖，女，1975年4月出生，吉林四平人，硕士研究生，副主任医师，吉林省眼科医师协会委员，吉林省中西医结合眼科分会委员。联系电话：15843100600；E—mail：156302397@qq．com
