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

目的观察激光治疗不同分期糖尿病视网膜病变(DR)的临床疗效。方法收集糖尿病性视网膜病变患者300例共408眼,根据眼底荧光素血管造影分为增殖前期(PPDR)246眼和增殖期(PDR)两组162眼。对两组糖尿病视网膜病变患者均行全视网膜光凝术。对比分析两组治疗后的视力及视野、眼底荧光造影(FFA)检查的结果。结果全视网膜光凝术后,PPDR组视力提高81眼(32.9%),PDR组视力提高37眼(22.8%),PPDR组视力提高者比率优于PDR组,差异有统计学意义(P<0.05);复查FFA情况,PPDR组有效率90.7%显著高于PDR组的79.6%,差异有统计学意义(P<0.05);PPDR和PDR两组的黄斑阈值敏感度变化手术前后比较均无显著性差异,而术后中心30°视野平均阈值敏感度均下降。结论早期进行视网膜光凝术虽对视野有一定损害,但仍可以保持或提高DR患者视功能。

Objective To analyze the effect of laser photocoagulation in treating diabetic retinopathy（ DR）. Methods 300 cases（ 408eyes） of inpatient and outpatient diabetic retinopathy patients were divided into two groups,preproliferative diabetic group（ PPDR） and proliferative diabetic retinopathy group（ PDR）. The two groups were treated by laser photocoagulation. The results of vision,visual fields and fundus fluorescein angiography（ FFA） were analyzed. The period of postoperation follow up was 1year. Results In all patients with panretinal photocoagulation,vision was improved in 81 eyes in PPDR group and in 37 eyes in PDR group（ P 〈 0. 05）. After one time panretinal photocoagulation,the effective rate was 90. 7% in group of PPDR and 79. 6% in PDR group. There was statistical difference between the two groups. And there were decrease in MTS in these two groups. Conclusion Panretinal photocoagulation in the early stage can significantly improve and keep the visual function of patients with diabetic retinopathy.