PASCAL激光一次性全视网膜光凝治疗增殖性糖尿病视网膜病变

Clinical observation of one time short-pulse pattern scan laser pan-retinal photocoagulation for proliferative diabetic retinopathy

目的:探讨模式化激光扫描(pattern scan laser,PASCAL)激光一次性完成全视网膜光凝(pan-retinal photocoagulation,PRP)治疗增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的疗效及优势。方法:临床检查确诊的PDR患者28例42眼纳入研究。其中,视力≥0.1者36眼,<0.1者6眼;伴黄斑水肿者11眼。所有患眼均经PASCAL激光一次性完成PRP治疗。伴黄斑水肿者联合应用PASCAL单点模式和/或黄斑模式。随访时间1a,观察治疗前后视力、眼底、FFA、OCT、视野的变化情况。结果:选取的42眼患者治疗过程中均无明显疼痛不适。视力提高、稳定、下降者分别为6、28、8眼;视网膜新生血管消退18眼(43%);视网膜新生血管病灶稳定12眼(29%);视网膜新生血管病灶活动12眼(29%)。随访期间5眼(12%)因玻璃体积血行玻璃体切割手术治疗。治疗后黄斑中心凹厚度及视野平均光阈值敏感度与治疗前相比无统计学差异(P>0.05)。结论:应用PASCAL多点模式一次性完成PRP治疗PDR安全、有效、便利。

AIM：To investigate the clinical efficacy and benefit of short-pulse pattern scan laser（PASCAL）photocoagulation for proliferative diabetic retinopathy（PDR）.METHODS：Twenty-eight PDR patients（42 eyes）underwent short-pulse PASCAL pan-retinal photocoagulation（PRP） were analyzed.The best corrected visual acuity was ≥0.1 in 36 eyes,0.1 in 6 eyes.Diabetic macular edema（DME） was found in 11 eyes.Short-pulse PASCAL PRP was performed and completed in one time.Macular edema was treated by single spot and/or PASCAL macular mode.Visual acuity,fundus examinations,fundus fluorescein angiography（FFA）,optical coherence tomography（OCT） and visual field were analyzed at the one-year follow-up period.RESULTS：All the cases had no pain during the shortpulse PASCAL treatment.One year after treatments,the final visual acuity was improved in 6 eyes,kept stable in 28 eyes and decreased in 8 eyes;neovascularization were regressed in 18 eyes（43%）,stable in 12 eyes（29%）,uncontrolled in 12 eyes（29%）.Five eyes（12%） received vitrectomy due to vitreous hemorrhage.Compared with before operation,retina thickness in central fovea of macula and visual field had no obvious change after one-time PASCAL PRP（P〉0.05）.CONCLUSION：The one-time short-pulse PASCAL PRP could stabilize the progress of PDR safely,effectively and simply.