氩激光治疗糖尿病视网膜病变的疗效观察

The effect of argon panretinal photocoagulation for diabetic retinopathy

目的:观察氩激光视网膜光凝治疗糖尿病视网膜病变的治疗效果。方法:选择经眼底血管荧光造影(FFA)确诊为增殖前期及增殖期的糖尿病视网膜病变患者56例(81眼),根据眼底荧光造影(FFA)的结果行标准全视网膜光凝,有临床意义的黄斑水肿者先行格栅样光凝,再行全视网膜光凝,治疗后3～12mo分别行眼底荧光造影,对需要者进一步补充光凝。观察治疗前后的视力、眼底荧光造影了解视网膜血管渗漏情况以及新生血管的变化。结果:全视网膜光凝81眼治疗后视力提高者22眼,占27%,视力不变52眼,占64%,有效率达91%,视力下降7眼,占9%。增生性糖尿病视网膜病变有6眼新生血管完全消退,占23%,15眼部分消退,占57%,增殖前期视网膜出血、渗出完全吸收13眼,23%,部分吸收35眼,64%,7眼不变,占13%。13眼合并有黄斑水肿者部分或完全消退7眼,占54%。结论:及时行氩激光全视网膜光凝治疗对于改善糖尿病视网膜病变的视功能有重要作用,无明显并发症发生。

AIM： To observe the effects of panretinal photocoagulation in the treatmnent of diabetic retinopathy. METHODS： The clinical data of 81 eyes （56 cases） with preproliferative and proliferative diabetic retinopathy were retrospectively analyzed. Standard panretinal photocoagulation was done according to the fundus fluorescein angiography. Grid photocoagulation was performed on patients with clinically significant macular edema. During the follow-up period of 3-12 months, fundus fluorescein angiography was carried out and cases requiring supplement were complemented with further photocoagulation. RESULTS： After treatment, visual acuity was improved in 22 eyes （27%）, maintained unchanged in 52 eyes （64%） and decreased in 7 eyes （9%）, with the effective rate of 91%. The retina neovasculer disappeared in 6 eyes （23%） and partialy in 15 eyes （57%）. Fluorescein seepage disappeared completely in 13 eyes （230）, partialy in 35 eyes （64%）. The macular edema was significantly absorbed in 7 eyes （54%）. CONCLUSION： The argon panretinal photocoagulation can play an important role in treating diabetic retinopathy for timely improving patients＇ prognostic visual function with few complications.