黄斑玻璃膜疣预防性激光治疗效果分析

Prophylactic laser treatment in eyes with large drusen

目的分析预防性激光治疗对大的黄斑玻璃膜疣的效果。方法黄斑部有多个（〉10个），大的（直径〉63μm）玻璃膜疣者23例。其中7例对侧眼为湿性年龄相关性黄斑变性，对玻璃膜疣眼进行激光治疗。另外16例为双眼玻璃膜疣，随机选择一只眼行激光治疗。氪黄激光“C”型光凝该23只眼的黄斑区。随访最佳矫正视力、彩色眼底像和眼底荧光造影（FFA）。结果激光治疗后，14只眼玻璃膜疣减少，7只眼玻璃膜疣无明显变化，2只眼玻璃膜疣增加。最佳矫正视力提高7只眼，不变6只眼，下降10只眼，最佳矫正视力术前术后统计分析无显著性差异。激光治疗眼并未出现脉络膜新生血管等并发症。结论氪黄激光对大的黄斑玻璃膜疣预防性激光治疗可以促进玻璃膜疣吸收，并使其视力保持稳定。

Objective To investigate the effect of prophylactic laser treatment in eyes with large soft drusen.Methods A total of 23 patients with large soft drusen were studied prospectively. Laser treatment was applied to 7 patients who had choroidal neovascularization membrane in the contralateral eye. 16 patients with bilateral drusen received laser treatment on one randomly assigned eye.Krypton yellow laser was applied in ＂C＂ pattern.Change in best corrected visual acuity, fundus photography and ftuorescein angiography were followed for mean 18 months.Results After photocoagulation, drusen reduced in 7 eyes, remained the same in 6 eyes, increased in 2 eyes.Best corrected visual acuity improved in 7 eyes, stabilized in 6 eyes, and declined in 10 eyes.It did not change significantly after laser treatment.No complication such as choroidal neovascularization （CNV）occurred.Conclusion Prophylactic laser treatment in eyes with large drusen causes a reduction in drusen area and may stabilize the visual acuity.