重度Ⅱ型视盘血管炎的早期全光凝治疗

Earlier panretinal photocoagulation for heavy typeⅡoptic disc vasculitis

目的研究重度Ⅱ型视盘血管炎(ODV)早期全光凝治疗的意义。方法将重度Ⅱ型ODV 25例(25眼)分为常规治疗组(13例)和早期激光治疗组(12例)。全部患者给予全身皮质类固醇激素,并辅以改善微循环和神经营养药物治疗。常规治疗组在随诊观察中出现虹膜新生血管后给予全视网膜光凝(PRP)治疗,早期激光治疗组在发病2周药物治疗的同时给予PRP治疗。对所有患者的视力、视野、眼压、虹膜新生血管、视乳头改变、眼底荧光血管造影等进行系统临床观察。结果随访1年,早期激光治疗组较常规治疗组视力显著提高,新生血管性青光眼发病率显著降低。结论重度Ⅱ型ODV患者早期PRP治疗可以提高视力,减少并发症,尤其是减少新生血管性青光眼的发生。

Objective To evaluate the therapeutic effect of panretinal photocoagulation（PRP） on heavy type lI optic disc vasculitis （ODV） in its early stage. Methods 25 hospitalized patients （ 25 eyes） with heavy type lI ODV were randomized into the routine treatment group （ n = 13 ） and the earlier laser treatment group （ n = 12）. The routine treatment group was treated by PRP after iris neovascularization could be observed and earlier laser treatment group began PRP treatment 2 weeks after the onset of the illness. All patients in the two groups were treated by eorticosteroid and other medicines to improve microcirculation and nerve nutrition. All patients were followed up for 1 year to observe visual acuity, vision field, intra ocular pressure, iris neovessels, optic disc and fluorescence fundus angiography. Results The visual acuity in the earlier laser treatment group was notably improved than in the routine treat- ment group during the follow-up. The neovascular glaucoma rate in the earlier laser treatment group was markedly decreased than in the routine treatment group. Conclusion Earlier PRP for patients with heavy type lI ODV can enhance the vision and reduce complications, especially for neovascular glaucoma.