激光治疗不同分期糖尿病视网膜病变的疗效观察

Effects of laser photocoagulation in treating diabetic retinopathy

目的研究532nm激光对不同分期糖尿病视网膜病变进行全视网膜光凝术的疗效。方法根据眼底荧光血管造影结果分为增殖前期组和增殖期组。对所有病例分3次进行全视网膜光凝术,每次治疗间隔一周。治疗结束后3个月、6个月及12个月行眼底荧光血管造影。对新生血管未消退或无灌注区残留病例补行激光治疗。结果全视网膜光凝术后3月,增殖前期组视力提高55眼(34.2%),增殖期组视力提高25眼(23.4%);两组视力提高率差异有统计学意义(P<0.05);增殖前期组有效率(90.7%),增殖期组有效率(78.5%),两组有效率差异有统计学意义(P<0.05)。全视网膜光凝术术后12个月,发生玻璃体积血18眼,13眼经药物治疗后吸收,5眼需行玻璃体切割手术治疗。并发牵拉性视网膜脱离7例。并发或加重白内障52例。结论糖尿病视网膜病变早期行激光治疗,能最大限度地降低糖尿病视网膜病变导致的视力损害。

Objective To observe the effects of laser photocoagulation in treating diabetic retinopathy（DR）. Methods All patienty were divided into two groups, pre-proliferative and proliferative diabetic retinopathy. Both groups were treated with laser photocoagulatlon. The fundus fluorescein angiography （FFA） were taken 3m, 6m, 12m after the treatment. Results In all patients with panretinal photocoagnlation, vision was improved in 55 eyes in PPDR group and in 25 eyes in PDR group（P〈0.05）. The effective rate was 146 eyes （90.7%） in group of PPDR and 84 eyes （78.5%） in PDR group. Conclusion Panretinal photocoagulation in the early stage can significantly improve and keep the visual function of patients with diabetic retinopathy.