氩激光治疗视网膜静脉阻塞57例

Clinical analysis of argon laser photocoagulation in the treatment of retinal vein occlusion

目的:分析57例氩激光光凝治疗视网膜静脉阻塞(retinal vein occlusion,RVO)的临床疗效。方法:随访我院57例被确诊为视网膜静脉阻塞并经氩激光光凝治疗后的患者,观察患者的视力、眼底改变以及并发症情况并评价氩激光光凝治疗视网膜静脉阻塞的临床价值。激光治疗方法分为黄斑区格栅样光凝,局灶性视网膜光凝及全视网膜光凝。结果:经氩绿激光光凝治疗57例后3～6mo给予复查:末次随访视力提高23眼,视力无明显变化25眼,视力下降9眼;激光治疗后复查荧光素眼底血管造影(观察视网膜毛细血管无灌注区面积变化及新生血管消退情况),治疗有效54眼,3眼发展为新生血管性青光眼(NVG)。而激光光凝对于黄斑部晚期并发症无明显效果。结论:激光光凝治疗可提高中心视力,可促进视网膜水肿、出血、渗出的吸收,同时减少视网膜静脉阻塞引起的新生血管,对于预防并延缓增殖性玻璃体视网膜病变和继发性新生血管性青光眼的发生有明显效果。

AIM：To analyze the effects of the argon laser photocoagulation in the treatment of retinal vein occlusion（RVO）.METHODS：Fifty-seven cases who were diagnosed as RVO and treated by argon laser photocoagulation were followed up. Observed the patients＇ visual acuity, fundus changes and complications, evaluated the clinical value of argon laser photocoagulation for RVO. Argon laser photocoagulation were divided into macularl attice photocoagulation, local retinal photocoagulation and panretinal photocoagulation.RESULTS：The 57 cases 3-6 months after argon laser photocoagulation were reexamined. The last visual acuity improved in 23 eyes, no change in 25 eyes, and decreased in 9 eyes. Fundus fluorescein angiography（FFA） was reexamined after laser photocoagulation（observing the area changes of retinal capillary non-perfusion area and the regression condition of new vessels）, the outcome was effective in 54 eyes, developed to NVG in 3 eyes. However, laser photocoagulation had no significant effect on macular late complications.CONCLUSION：Laser photocoagulation treatment can improve central visual acuity, promote the absorption of retinal edema, hemorrhage and exudation, at the same time reduce the new vessels caused by NVG, also have remarkable effect in preventing or delaying the proliferative vitreoretinopathy and secondary neovascular glaucoma.