氪黄激光治疗非增殖性糖尿病性视网膜病变黄斑囊样水肿的临床效果观察

A clinical observation of krypton yellow laser photocoagulation for cystoid macular edema in nonproliferative diabetic retinopathy

目的 评价氪黄激光治疗非增殖性糖尿病性视网膜病变（ｎｏｎｐｒｏｌｉｆｅｒａｔｉｖｅ ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＮＰＤＲ） 所致的黄斑囊样水肿（ｃｙｓｔｏｉｄ ｍａｃｕｌａｒｅｄｅｍａ，ＣＭＥ） 的临床效果。方法 对３７ 例（５２ 只眼） ＮＰＤＲ 所致ＣＭＥ患者行氪黄激光局部或格栅状黄斑区光凝，按病程分为≤６ 个月和≥７ 个月两组病例，随访１ 年，观察光凝后不同时期患者视力及黄斑水肿的变化，并进行统计学分析。结果 光凝前视力０２７ ±０２１ ，光凝后为０５３ ±０２６（ Ｐ＜ ００１ ） 。视力提高者为９０４ ％ ，不变者为５８％ ，下降者为３８ ％ 。ＣＭＥ完全消退者为５５８ ％ ，部分消退者为４２３ ％ ，不变者为１９ ％ ，术后１ 个月即达到较理想状态。病程≤６ 个月组，光凝后１ 个月时视力提高者即达８１５ ％ ，６ 个月时达１０００ ％ ，水肿完全消退者为７０４ ％ ，部分消退者为２９６ ％ 。病程≥７ 个月组，光凝后１ 个月时视力提高者仅为２００％ ，６ 个月时方达８８０ ％ ，水肿完全消退者为４００ ％ ，部分消退者为５６０ ％ 。两组患者视力恢复速度及疗效差异有显著性（Ｐ＜ ００１） 。

Objective To evaluate the clinical effects of krypton yellow laser photocoagulation for cystoid macular edema (CME) in nonproliferative diabetic retinopathy (NPDR) Methods 52 eyes (37 cases) with CME in NPDR were treated with local or grid macular krypton yellow photocoagulation, and according to the course they were divided into two groups: group I (≤6 months) and group II (≥7 months) The follow up was 1 year The visual acuity and the degree of macular edema in various period were analyzed and compared Results The mean visual acuity was 0 27±0 21 before treatment and 0 53±0 26 after treatment ( P <0 01), 90 4% was increased, 5 8% was stable and 3 8% was decreased CME disappeared completely in 55 8% of the patients, disappeared partially in 42 3% and stable in 1 9% In group I the visual acuity was improved in 81 5% of the patients at post treatment 1 month; at post treatment 6 months, the visual acuity was increased in 100% of the cases, CME disappeared completely in 70 4% and disappeared partially in 29 6% In group II, the visual acuity was improved in 20% of the patients at post treatment 1 month, and at post treatment 6 months in 88%, CME disappeared completely in 40% and disappeared partially in 56% The differences in the rate of visual recovery and therapeutic effects between the two groups were statistically significant ( P <0 01) Conclusions Krypton yellow laser is prominently effective and selective for CME in NPDR The effects are related to the course of the disease, and the therapeutic results are better in cases receiving early treatment