相干光断层扫描对532nm激光治疗糖尿病黄斑水肿的疗效观察

Observation of optical coherence tomography on 532nm laser photocoagulation in the treatment of diabetic macular edema

目的评价使用相干光断层扫描(OCT)对532 nm激光治疗糖尿病黄斑水肿的疗效进行观察的有效性。方法对糖尿病性有临床意义的黄斑部水肿病例46例(61只眼),给予532 nm激光黄斑格栅样光凝、局灶光凝以及全视网膜光凝,在治疗前、治疗后3个月分别进行裸眼视力、眼底照相、荧光素眼底血管造影及OCT黄斑区视网膜厚度及视网膜容积等检查。比较光凝前后黄斑区视网膜厚度和视网膜容积的变化。结果在46例(61只眼)中,41只眼视力提高,17只眼不变,所有患者荧光素眼底血管造影显示黄斑区荧光渗漏不同程度减轻或消失,OCT显示光凝治疗前黄斑中心凹视网膜神经上皮厚度为(354.7±93.2)μm,光凝3个月后为(203.5±49.6)μm(P<0.05),光凝治疗前黄斑区6 mm直径神经上皮总体容积为(8.32±0.53)mm3,光凝3个月后为(7.24±0.41)mm3(P<0.05)。结论 OCT可以对糖尿病性黄斑水肿进行定量的诊断,并且可以对激光光凝治疗后黄斑水肿的消退进行准确的测量和评价。

Objective To observe the clinical effect of 532nm laser photocoagulation therapy on diabetic macular edema with optical coherence tomography.Methods 46 continuous patients（61 eyes） with clinically significant diabetic macula edema were treated by 532nm laser photocoagulation.The retinal thickness and the volume of central fovea of macula were detected by optical coherence tomography in pre-photocoagulation and post-photocoagulation after 3 months.These data and the visual acuity were analyzed statistically.Results The visual acuity in 41 eyes improved and 17 eyes unchanged after 532 nm photocoagulation.The retinal thickness and the volume of central fovea of macula in pre-photocoagulation and post-photocoagulation after 3 months were 354.7±93.2 μm/ 8.32±0.53 mm3 and 203.5±49.6 μm/7.24±0.41 mm3 respectively.Statistically,the difference in pre-photocoagulation and post-photocoagulation was significant.Conclusion 532nm laser photocoagulation is an effective treatment for diabetic macular edema.The change of retinal thickness and the volume can be measured exactly with optical coherence tomography pre-and post-photocoagulation,and thus the accurate effect of 532nm laser photocoagulation can be evaluated exactly.