摘要
目的 577 nm多点微脉冲激光治疗重度非增殖期糖尿病视网膜病变(severe non-proliferative diabetic retinopathy, SNPDR)的临床效果。方法采用前瞻性随机对照试验2018-06/2019-06月招摹双眼SNPDR患者,将患者双眼随机分为577 nm多点微脉冲激光组和532 nm传统单点氩激光组。两组均行全视网膜光凝(panretinal photocoagulation, PRP)治疗。评估患者基线、3、6、12个月的最佳矫正视力(best corrected visual acuity, BCVA)、眼底照相、眼底荧光血管造影(fundus fluorescein angiography, FFA)、光学相干断层成像术(optical coherence tomography, OCT)、视野检查情况。主要结果观察指标包括视力改变、黄斑中心凹厚度(central macular thickness, CMT)、视野参数(visual field index, VFI)。次要结果观察是否进展到增殖期糖尿病视网膜病变(proliferative diabetic retinopathy, PDR)。结果在12个月随访期末,两组均无患眼进展为PDR。两组患者在BCVA、CMT方面差异无统计学意义(P>0.05),577 nm多点微脉冲激光治疗组视野受损程度明显低于532 nm传统单点氩激光组,差异有统计学意义(P=0.04)。结论 577 nm多点微脉冲激光治疗SNPDR与532 nm传统单点氩激光治疗效果相当,且不良反应明显减少,可以作为替代方案从而避免并发症。
Objective To study the clinical efficacy of 577 nm multi-spot micropulse laser for severe non-proliferative diabetic retinopathy(SNPDR). Methods The SNPDR patients from Jun 2018 to Jun 2019 were enrolled by prospective randomized controlled trials. Eyes of patients were randomly divided into 577 nm multi-spot micropulse laser group and 532 nm conventional single-spot argon laser group. All paitents were treated with panretinal photocoagulation(PRP). The best corrected visual acuity(BCVA),fundus photograph, fundus fluorescein angiography(FFA), optical coherence tomography(OCT) and visual field were measured at baseline, 3-, 6-and 12-month. The main outcome measures including change in visual acuity, central macular thickness(CMT), the visual field index(VFI). Secondary outcome were observed to see if progression to proliferative diabetic retinopathy(PDR). Results During the 12-month follow-up, no eye progressed to PDR. The BCVA, CMT were no significantly differences between the two groups(P>0.05). The degree of VFI of 577 nm multi-spot micropulse laser group was significantly decreased than that of the 532 nm conventional single-spot argon laser group(P=0.04). Conclusion The 577 nm multi-spot micropulse laser has the same effect as the 532 nm conventional single-spot argon laser on SNPDR,and less complications, which can be used as an alternative to avoid complications.
作者
段淯平
张祺
金中秋
DUAN Yuping;ZHANG Qi;JIN Zhongqiu(Department of Ophthalmology,Wuhan Eyegood Ophthalmic Hospital,Wuhan Hubei 430019,China)
出处
《华南国防医学杂志》
CAS
2021年第1期14-17,43,共5页
Military Medical Journal of South China
基金
武汉市卫生健康委员会20192020年面上项目(WX19D35)。
