光凝对糖尿病视网膜病变黄斑区视网膜厚度的早期影响

Early influence of laser photocoagulation on macular retinal thickness in diabetic retinopathy

目的 探讨视网膜光凝术对糖尿病视网膜病变 (diabetic retinopathy,DR)黄斑区视网膜厚度的早期影响。 方法 应用 Zeiss- Humphrey光学相干断层扫描成像仪观察和定量分析 2 1例 30只眼 ～ 期 DR患者视网膜光凝术前、术后第 3天和第 7天的黄斑中心凹和距离黄斑中心凹 75 0 μm处神经上皮厚度和色素上皮厚度的改变。 结果 光凝术后第 3天 ,黄斑中心凹神经上皮厚度较术前显著增加 ,其变化值与年龄、血糖、DR病程呈显著的正相关 ,术后第 7天恢复至术前水平 ;距黄斑中心凹 75 0 μm处的神经上皮厚度和色素上皮厚度无显著改变。 结论 视网膜光凝术能够引起 DR眼术后早期的黄斑水肿或使原有的黄斑水肿加重 ,表现为黄斑中心凹神经上皮厚度的增加 ,老龄、血糖水平高。

Objective To investigate the early influences of laser photocoagulation on macular retinal thickness in diabetic retinopathy(DR). Methods Optic coherence tomography examination was performed in 30 eyes with DR(phase Ⅲ~Ⅳ) before, and on the 3rd day and the 7th day after photocoagulation respectively. The thickness of neuroretina and pigment epithelium were measured in the areas of fovea macula and 750 μm from fovea macula. Results Three days after photocoagulation, significant thickening of neuroretina was observed in the fovea macula, which is positively related with age, fasting blood sugar and duration of DR. There was no significant changes in the thickness of pigment epithelium in macula and in the thickness of neuroretina 750 μm from fovea macula. Conclusion Significant thickening of neuroretina in fovea macula in DR early after photocoagulation reveals progressed macular edema induced by photocoagulation which is positively related with age, fasting blood sugar and duration of DR.