全视网膜激光光凝术治疗糖尿病视网膜病变后视网膜及视网膜神经纤维层厚度的变化

The Change of Retina and Retinal Nerve Fiber Layer Thickness of Diabetic Retinopathy after Pan Retinal Photocoagulation

目的:探讨全视网膜激光光凝术治疗糖尿病视网膜病变后视网膜及视网膜神经纤维层厚度的变化。方法:选取2012年9月-2015年8月于笔者所在科室诊断糖尿病视网膜病变(DR),并实施全视网膜激光光凝术(panretinal photocoagulation,PRP)治疗的患者18例(36眼),应用光学相干断层扫描(OCT)检测PRP治疗前后DR患者黄斑区视网膜厚度、黄斑中心凹容积、视乳头旁视网膜神经纤维(RNFL)厚度,将治疗前后数据进行比较。另选取笔者所在医院诊断DR而未行PRP治疗的患者11例(22眼),对患者黄斑区视网膜厚度、黄斑中心凹容积、视乳头旁RNFL进行检查,观察随访后其变化情况。结果:PRP治疗前治疗组及对照组患者黄斑区视网膜厚度、黄斑中心凹容积、视乳头旁RNFL厚度比较,差异无统计学意义(P>0.05),而治疗组患者行PRP治疗后,黄斑区视网膜平均厚度、黄斑中心凹容积增加,视乳头旁RNFL厚度变薄,差异有统计学意义(P<0.05),对照组患者随访后黄斑区视网膜厚度、黄斑中心凹容积、视乳头旁RNFL厚度无明显变化,差异无统计学意义(P>0.05)。结论:DR患者在接受PRP治疗半年后,可使RNFL变薄,黄斑区视网膜厚度、黄斑中心凹容积增加。

Objective： To detected the change of retina and retinal nerve fiber layer thickness of diabetic retinopathy after pan retinal photocoagulation. Method： A total of 18 patients（36 eyes） diagnosed diabetic retinopathy（DR） in our department and treated with pan retinal photocoagnlation（PRP） from September 2012 to August 2015 were selected to observe the change of macular retinal thickness macular center concave volume and peripapillary retinal nerve fiber layer（RNFL） thickness before and after PRP treatment by using optical coherence tomegraphy（OCT）.Furthermore, a total of 11 patients（22 eyes） diagnosed DR in our department but not treated with PRP were selected for the detection of macular retinal thickness macular center concave volume and peripapillary RNFL thickness to observe the change before and after follow-up.Result： The macular retinal thickness, macular center concave volume and peripapillary RNFL thickness were not statistically significant difference compared with those of the control group before treatment（P〉0.05）.And after PRP treatment, the average macular retinal thickness and macular center concave volume in the DR of the treatment group increased and the thickness of the peripapillary RNFL thickness decreased, with statistically significant differences（P〈0.05）.The macular retinal thickness, macular center concave volume and peripapillary RNFL thickness of the control group were not change with statistically significant difference before and after follow-up（P〉0.05）.Conclusion： The PRP treatment can decrease the peripapillary RNFL thickness and increase the macular retinal thickness and macular center concave volume in the DR.