局灶性光凝治疗视网膜分支静脉阻塞的临床疗效分析

Analysis for clinical efficacy of focal photocoagulation in the treatment of branch retinal vein occlusion

目的观察局灶性光凝治疗视网膜分支静脉阻塞(BRVO)的临床疗效。方法收集我院BRVO患者80例(80只眼),随机数字法分为光凝组和对照组各40例。两组均予以基础药物治疗(复方血栓通胶囊,复方樟柳碱注射液穴位注射,卵磷脂络合碘片-沃丽汀,维生素C片等)。光凝组结合患者荧光素眼底血管造影(FFA)检查设计局灶性光凝方案,如存在黄斑水肿者添加黄斑格栅样光凝方案,对于视网膜水肿可能波及黄斑部者添加堤坝式光凝方案,治疗后3、6、9、12个月复查眼底及FFA,如存在新生血管,则继续进行光凝。观察两组患者治疗前后视力、FFA、视野变化。结果光凝组患者有效率为85%,对照组患者有效率为47.5%,两组患者有效率经统计学分析,光凝组有效率明显高于对照组,P<0.05,差异具有统计学意义。光凝组患者平均敏感度、平均缺损治疗前后比较,P>0.05,差异无统计学意义,说明此两项无明显变化。对照组平均敏感度治疗后明显低于治疗前,治疗后平均缺损则高于治疗前,P<0.05,差异具有统计学意义。两组治疗后相比,光凝组平均敏感度明显高于对照组,而平均缺损则明显低于对照组,P<0.05,差异具有统计学意义。结论 BRVO早期实施局灶性光凝可减少患者新生血管生成,同时控制患者视野进一步下降,具有积极的意义,但远期疗效尚需进一步观察。

Objective To observe the clinical efficacy of focal photocoagulation for the treatment of branch retinal vein oechision （BRVO）. Methods Eighty patients （ 80 eyes） with BRVO were randomly divide into two groups （40 pa- tients each group ）. All patients were given same drug treatments （including compound Xue-shuan-tong capsule, compound anisedine injection, iodized lecithin tablets, vitamin C tablets, ete）. Patients in treatment group received focal photocoagu- lation with or without maeular grid photocoagulation, depending on whether maeular edema was presented. Dam type photo- coagulation was added for those retinal edema might spread to maeular region. After 3, 6, 9, 12 months of the treatment, patients were examined for fundus and FFA. Residual neovaseularization warranted additional focal photocoagulation. Visu- al acuity, visual field and FFA were followed. Results Effective rate of photocoagulation group was 85%, signitlcanfly higher than that of control group was （47.5% ）. Mean sensitivity and mean defect did not change in photocoagulation group after the treatment. In contrast, both mean sensitivity and men defect became worse in control group after treatment （P 〈 0.05 ）. Sensitivity and defect are significantly better in photocoagulation group than in control group （P 〈 0.05）. Con- dusion Early focal photecoagulation treatment for BRVO could reduce the development of neovascularization and prevent visual field declining.