摘要
目的观察532 nm激光治疗糖尿病视网膜病变的临床疗效。方法糖尿病视网膜病变患者152例208只眼,分为重度非增殖性糖尿病视网膜病变（nonproliferative diabetic retinopathy,NPDR）104例144只眼,增殖性糖尿病视网膜病变（proliferative diabetic retinopathy,PDR）48例64只眼,均采用532 nm倍频Nd∶YAG激光行标准全视网膜激光光凝或超全视网膜激光光凝,对合并黄斑水肿者行局限光凝或格栅光凝。术后6-24个月随访,无灌注区或新生血管未消退者行补充光凝,观察各组最佳矫正视力、眼底血管造影（fundus fluorescein agiography,FFA）及眼底视网膜病变进展变化。结果重度NPDR组视力提高和不变115只眼（占79.9%）,PDR组视力提高和不变47只眼（占73.4%）,两组比较差异有显著意义（P〈0.05）;眼底视网膜改变,重度NPDR组有效率81.9%,PDR组有效率71.9%,两组比较差异有显著意义（P〈0.05）;39只眼因黄斑水肿行黄斑局限光凝或格栅光凝,24只眼水肿减轻或消退。结论采用激光治疗DR的临床疗效显著,重度NPDR组疗效好于PDR组,选择合适的时机和有效的光凝治疗是稳定视力和延缓眼底病变的关键。
Objective To evaluate the clinical effectiveness of 532 wave length Nd ： YAG laser photocoagulation for diabetic retinopathy. Methods 208 eyes of 152 patients who suffered from diabetic retinopathy received laser treatment, including 144 eyes of severe nonproliferative diabetic retinopathy（NPDR） and 64 eyes of proliferative diabetic retinopathy（PDR）, these patients received the treatment of standard panretinal photocoagulation （PRP） and extra panretinal photocoagulation, those with macular edema received the focal and grid photocoagulation. The follow-up period was 6-24 months, and the examinations of best corrected visual acuitv, the fundus fluores-cein agiography （FFA） and fundus examination were conducted after treatment. For those with remaining new vessels and non-perfusion areas, the treatment was complemented with further photocoagulation. Results Visual acuity were improved or maintained in 115 eyes （ about 79.9% ） of NPDR group and 47 eyes （ about 73.4% ） of PDR group, the difference was statistically significant（P 〈0. 05） ;Retinal new vessels and non-perfusion partly or entirely regressed in 118 eyes （about 81.9% ） of NPDR group and 46 eyes （about 71.9% ） of PDR group, the difference was statistically consignificant（P〈0.05）. After grid photocoagulation in 39 eyes with diffuse edema, the lesion was considerably improved or disappeared in 24 eye Conclusions Nd：YAG（532 nm） laser photocoagulation is obviously effective in treatment of diabetic retinopathy, the clinical therapeutic effect is better in sever NPDR than PDR, choosing suitable time and effective photocoagulation are the keys of maintaining visual acuity and preventing progression of diabetic retinopathy.
出处
《中国激光医学杂志》
CAS
CSCD
2016年第2期65-69,共5页
Chinese Journal of Laser Medicine & Surgery
作者简介
李昂（1970-），女，辽宁沈阳人，主治医师，硕士，主要研究眼底病的激光治疗。
