激光光凝治疗视网膜分支静脉阻塞的疗效观察

Clinical observation of laser photocoagulation for branch retinal vein occlusion

目的探讨激光光凝治疗视网膜分支静脉阻塞的临床疗效。方法被确诊为视网膜分支静脉阻塞并经激光光凝治疗的患者37例(37眼),观察治疗前后的视力、眼底彩照及荧光素眼底血管造影(fluorescein fundus angiography,FFA)的变化和并发症,光凝术后3个月、6个月、12个月复查FFA,若发现无灌注区及新生血管未消退,给予追加光凝治疗。结果视力提高27眼(72.97%),不变8眼(21.62%),降低2眼(5.41%)。经1～3次光凝治疗后,FFA结果示黄斑水肿消退,无灌注区大部分消失,无新生血管形成。激光光凝治疗前有新生血管4眼,治疗后完全退缩。1眼在治疗8个月时发生玻璃体出血,12眼黄斑部有硬性渗出。结论激光光凝治疗能促进出血、渗出的吸收,减轻黄斑水肿,保护视功能,降低新生血管形成,有效防止增生性玻璃体视网膜病变和预防继发性新生血管性青光眼等并发症的发生。

Objective To investigate the clinical efficacy of laser photocoagulation for branch retinal vein occlusion.Methods Changes of visual acuity,ocular fundus photograph and fundus fluorescein angiography（FFA） were observed before and after treatment in 37 cases（37 eyes）,who were diagnosed with branch retinal vein occlusion and treated with laser photocoagulation.FFA was rechecked at 3 months,6 months and 12 months after laser photocoagulation.And laser photocoagulation was taken again if there was no perfusion area or neovascularization was not extinct.Results Visual acuity improved in 27 eyes（72.97%）,unchanged in 8 eyes（21.63%） and decreased in 2 eyes（5.41%）.After laser photocoagulation for 1 to 3 times,FFA showed that leakage at macular area was disappeared,non-perfusion area extincted and neovaucularization was not formed.There were 4 eyes with neovascularization before laser treatment and completely extinceted after treatment.There was 1 eye with vitreous hemorrhage at 8 months after treatment and 12 eyes with hardness exudation.Conclusion Laser treatment can promote the absorption of hemorrhage and exudation,lessen macular edema,protect visual function,decrease the formation of neovascularization and effectively prevent complications like proliferative vitreoretinopathy and secondary neovascular glucoma.