氩激光治疗糖尿病性黄斑水肿的临床观察

A clinical study on argon laser photocoagulation in the treatment of macula edema for diabetic retinopathy

目的：探讨氩激光治疗糖尿病性黄斑水肿的方法以及治疗时机和效果。方法：对接受氩激光治疗２９例（３８只眼）糖尿病性黄斑水肿患者的临床资料进行了回顾性研究。局灶性水肿患者直接光凝渗漏的微血管瘤（光斑５０～１００μｍ，时间０１ｓ，能量１００～３００ｍＷ，光斑反应Ⅱ级）；弥漫性水肿者采用格栅光凝（光斑１００～２００μｍ，时间０１ｓ，能量１００～２００ｍＷ，光斑反应Ⅰ～Ⅱ级）。结果：３８只眼中视力提高者１１只眼（２８９％），视力无变化者２０只眼（５２６％），视力下降者７只眼（１８４％）。水肿完全消退者１２只眼（３１６％）；部分消退者１８只眼（４７４％），无变化或加重者８只眼（２１％）。结论：糖尿病性黄斑水肿经适当激光光凝治疗可以减轻或消除大部分糖尿病性视网膜病变患者的黄斑水肿，提高或保存现有视力。

OBJECTIVE: To explore the method opportunity and effect on argonlaser photocoagulation in the treatment of the diabetic macula edema METHODS: The retrospective study was completed on clinical data from 29 patients (38 eyes) with diabetic macula edema which were treated with argon laser photocoagulation Local focus of edema were treated with direct photocoagulation of microaneurysms ( 50～100μm spot sizes, 0 1 second, 100～300 mW, reaction grades Ⅱ) Diffuse macula edema were treated indirectly with grid photocoagulation (100～200μm spot sizes, 0 1 second, 100～200mW, reaction grades Ⅰ～Ⅱ) RESULTS: Eleven (28 9%) of the 38 eyes had a improved visual acuity Twenty eyes (52 6%) had the unchanged visual acuity Seven eyes (18 4%) had worse than before treatment Macular edema disappeared completely in 12 eyes (31 6%), and partly in 18 eyes (47 4%), unchanged or aggravated in 8 eyes (21%) CONCLUSIONS: The majority of the macular edema of the patients with diabetic could be removed or alleviated through suitable laser photocoagulation, macular edema should be treated with laser photocoagulation, and the visual acuity of them could be kept or improved