多点与单点激光治疗增殖性糖尿病视网膜病变的疗效比较（英文）

Pattern scan laser versus single spot laser in panretinal photocoagulation treatment for proliferative diabetic retinopathy

目的:观察577-nm多点激光用于新近诊断的增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)行全视网膜光凝(panretinal photocoagulation,PRP)的疗效。方法:该前瞻性对照研究共纳入32例40眼PDR患者,随机分为2组,每组16例患者(20眼)。第1组采用多点激光(pattern scan laser,PSL)行PRP治疗,第2组采用单点激光(single spot laser,SSL)治疗。所有患者在PRP治疗前与最后一次PRP治疗后3mo均行荧光素眼底血管造影检查(fundus fluorescein angiography,FFA),以判断是否存在无灌注区。激光点数、完成PRP的治疗次数、治疗时长以及患者在治疗时的疼痛程度均作为判断指标。结果:PSL组患者需3次治疗以完成PRP,而SSL组需4次完成。第1组每次治疗时间为7.3±2.3min,较第2组的时间(13.2±4.1min)明显缩短(t38=5.596,P<0.01)。第1组的治疗疼痛指数较第2组明显降低(P<0.01)。最后一次PRP治疗3mo后复查FFA,第1组有5眼(25%)出现无灌注区,而第2组有8眼(40%)出现无灌注区,需要进一步治疗。结论:多点激光用于PDR行PRP治疗较单点激光有着明显的优势。它具有效率高,治疗疼痛轻,疗效好的特点。

AIM：To investigate the efficacy of 577-nm pattern scan laser in panretinal photocoagulation（PRP） treatment in newly diagnosed proliferative diabetic retinopathy（PDR）.METHODS：Prospective and comparative observation was performed in totally 32 patients with high-risk PDR.They were randomly divided into group 1（using pattern scan laser,PSL） and 2（using single spot laser,SSL）,each containing 16 subjects to which totally 20 eyes received PRP.Non-perfusion region was identified with fundus fluorescein angiography（FFA） before and 3mo after final PRP.The advantage of PSL was verified in terms of the number and the duration of PRP sessions needed for satisfactory outcomes,and the pain score.RESULTS：Three PRP sessions were needed for each eye to complete the treatment using PSL,while 4 sessions were needed using SSL.The duration of each session with PSL in group 1 was 7.3 ± 2.3min,which was significantly shorter than that with SSL in group 2（13.2±4.1,t_（38）=5.596,P〈0.001）.Treatment-related pain score was also significantly lower in group 1 than in group 2（P0.01）.Three months after the final PRP,the number of eyes with retinal non- perfusion regions that required additional treatment was 5（25%） in group 1 and 8（40%）in group 2.CONCLUSION：PSL showed clear advantages over SSL in the PRP treatment of PDR,not only in the improved efficacy,but also in the reduction of pain and the improvement of effectiveness.