摘要
目的观察改良全视网膜光凝顺序和传统全视网膜光凝对重度非增殖期糖尿病性视网膜病变患者中心视力和黄斑厚度的短期影响。方法临床病例对照研究。对2011年8月至2013年10月在郑州市第三人民医院眼科选取经FFA和OCT检查确诊的的重度非增殖期糖尿病性视网膜病变（SNP-DR）且不伴临床意义黄斑水肿患者68例136只眼。选取右眼为治疗组（改良PRP组），左眼为对照组（传统PRP组），每组68只眼。治疗组先行全视网膜镜下黄斑区格栅样光凝联合视盘周光凝及下方视网膜赤道部及远周边光凝，而后行鼻侧、颞侧、上方的赤道部及远周边视网膜光凝，对照组采取视网膜颞下、鼻下、颞上、鼻上分四次行全视网膜光凝，对比分析两组治疗后1天、1周、1月、3月、6月的最佳矫正视力（BCVA）和黄斑中心视网膜厚度（CMT）的变化。结果两组治疗前的基线特征有很好的匹配性，年龄、基线最佳矫正视力、基线CMT值在两组间差异均无统计学意义（P〉0．05），具有很好的可比性。两组治疗后最佳矫正视力（BCVA）在术后1天、1周及1月呈现轻微下降趋势。术后3月及术后第6月缓慢上升趋势，视力有所增进。BCVA在术后1天、1周及术后1月的两组间比较，差异无统计学意义（P〉0．05），术后3月和术后6月差异有统计学意义（P〈0．05）。两组治疗后CMT在术后1天及1周呈现轻微上升，术后1月、3月及6月由上升转为下降趋势，趋势转折时间点位于术后1周和术后1月之间，且CMT值在术后6月较术前有所升高。两组在术后1天、1周、和术后1月的比较差异无统计学意义（P〉0．05），术后3月和术后6月差异有统计学意义（P〈0．05），且术后6月两组CMT值比较，治疗组CMT低于对照组。结论据治疗后半年内的短期疗程观察，改良法PRP更充分，与传统PRP相比，有利于提高视力，减轻黄斑�
Objective To observe the short-term impact of modified panretinal photocoagulation and traditional panretinal photocoagulation on the treatment of patients with severe non-proliferative diabetic retinopathy in center vision and macular thickness. Methods Sixty-eight patients （136 eyes） with severe non-proliferative diabetic retinopathy （SNPDR） diagnosed by fluorescine ftmdus angiography （FFA） and without clinical significant diabetic macular edema （DME） diagnosed by optical coherence tomography （OCT） were selected. The right eye was selected as treatment group （modified PRP group） and the left eye as control group （conventional PRP group）, each group consisted of 68 eyes. No significant differences were found in the best-corrected visual acuity （BCVA） and in the central macular thickness （CMT） before treatment between two groups. The treatment group was performed macular grid photocoagulation combined with peripapillary retina, inferior equator retina and far peripheral retina photocoagulation by Volk retinoscope. Then laser coagulation was placed over the nasal, temporal, superior equator and far peripheral retinal. Goldmann three-mirror lens was used to treat temporal inferior, nasal inferior, temporal superior, and nasal superior areas sequentially four times on control group. The follow-up time was 1 day, 1 week, 1 month, 3 months and 6 months. The best-corrected visual acuity （BCVA） and central macular thickness （CMT） were mea- sured. Results The matching of the demographic characteristics was good between two groups before treatment. No significant differences were found in the age, the BCVA and the CMT before treatment between two groups （P 〉0.05）. The BCVA was showed a slight downward trend in 1 day, 1 week, and 1 month after treatment and a slow ascending trend in 3 months and 6 months after treatment, in the end, the visual acuity improved too. The comparison in BCVA in two groups was not significant different in 1 day, 1 week and 1 month after PRP （P
出处
《中国实用眼科杂志》
2016年第2期109-113,共5页
Chinese Journal of Practical Ophthalmology
关键词
全视网膜光凝
重度非增殖期糖尿病性视网膜病变
黄斑厚度
Panretinal photocoagulation
Severe non-proliferative diabetic retinopathy
Central macular thickness
