上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (2): 185-.doi: 10.3969/j.issn.1674-8115.2012.02.013

• 论著（临床研究） • 上一篇    下一篇

黄斑局灶/格栅样光凝联合全视网膜光凝治疗重度非增殖性糖尿病视网膜病变的临床分析

金慧昳, 杨晓璐, 谢田华, 刘 堃, 许 迅   

  1. 上海交通大学附属第一人民医院眼科, 上海 200080
  • 出版日期:2012-02-28 发布日期:2012-02-28
  • 通讯作者: 刘 堃, 电子信箱: drliukun@gmail.com。
  • 作者简介:金慧昳（1983—）, 女, 博士生；电子信箱: superbaby_jin@163.com。
  • 基金资助:

    四川省重点技术创新项目（2010PT004）；上海市眼底病重点实验室开放课题基金（07Z22911）

Clinical analysis of combination treatment of macular focal/grid laser photocoagulation and panretinal photocoagulation for severe nonproliferative diabetic retinopathy

JIN Hui-yi, YANG Xiao-lu, XIE Tian-hua, LIU Kun, XU Xun   

  1. Department of Ophthalmology, the First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China
  • Online:2012-02-28 Published:2012-02-28
  • Supported by:

    Sichuan Province Key Technological Innovation Project, 2010PT004； Shanghai Key Laboratory for Ocular Fundus Diseases Foundation, 07Z22911

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摘要：

目的 探讨黄斑局灶/格栅样光凝联合全视网膜光凝（PRP）治疗对重度非增殖性糖尿病视网膜病变（NPDR）患者黄斑区形态和功能的影响。方法 以28例（36眼）重度NPDR患者作为研究对象，根据最佳矫正视力、眼底照相、眼底荧光血管造影、光学相干断层扫描（OCT）和MP-1微视野仪的检查结果分为重度NPDR伴有临床意义黄斑水肿组（CSME组，n=20）和重度NPDR无黄斑水肿组(NE组，n=16）。所有患眼均接受黄斑局灶/格栅样光凝联合PRP光凝治疗，3个月后随访复查最佳矫正视力、OCT和微视野。结果 两组患者治疗前后的最佳矫正视力和黄斑区视网膜厚度比较差异均无统计学意义（P>0.05），CSME组患者治疗前后的视网膜光敏度无明显变化（P> 0.05），而NE组患者治疗后的视网膜光敏度较治疗前显著下降（P<0.05）。结论 对于无黄斑水肿的重度NPDR患者，黄斑局灶/格栅样光凝联合PRP治疗具有预防黄斑区视网膜增厚的作用，但对视功能有一定的损伤。

关键词: 糖尿病性视网膜病变, 激光光凝术, 光学相干断层扫描, 视功能

Abstract:

Objective To investigate the effects of combination treatment of macular focal/grid laser photocoagulation and panretinal photocoagulation (PRP) on macular morphology and function in patients with severe nonproliferative diabetic retinopathy (NPDR). Methods Thirty-six eyes of 28 patients with severe NPDR were selected, and were divided into severe NPDR with clinical significant macular edema group (CSME group, n=20) and severe NPDR without macular edema group (NE group, n=16) based on the findings of best corrected visual acuity, fundus photography, fluorescein fundus angiography, optical coherence tomography (OCT) and MP-1 microperimetry. Combination treatment of macular focal/grid laser photocoagulation and PRP was performed in all included eyes, and examinations of best corrected visual acuity, OCT and MP-1 microperimetry were conducted 3 months after treatment. Results There was no significant change in best corrected visual acuity and macular thickness after treatment in two groups (P>0.05), there was no significant change in retinal sensitivity after treatment in CSME group (P>0.05), while the retinal sensitivity after treatment was significantly lower than that before treatment in NE group (P<0.05). Conclusion Combination treatment of macular focal/grid laser photocoagulation and PRP is effective in preventing macular retinal thickening in patients with severe NPDR and no macular edema, while it may cause visual function impairment.

Key words: diabetic retinopathy, laser photocoagulation, optical coherence tomography, visual function