非缺血型视网膜中央静脉阻塞局部视网膜光凝的疗效

Efficacy of partial retinal photocoagulation in the treatment of nonischemic central retinal vein occlusion

目的观察局部视网膜光凝治疗非缺血型视网膜中央静脉阻塞（CRVO）的效果。方法65例（65眼）非缺血型CRVO随机分为3组，A组给予药物口服，B组在口服药物基础上联合局部视网膜光凝，c组在口服药物基础上进行轻度广泛视网膜光凝，B组和c组必要时行黄斑区局灶性光凝或格栅样光凝。观察患者治疗前及治疗后3个月和6个月的视力、视野及视网膜情况。结果治疗后6个月，各组视力及视网膜情况均有改善，B组和C组均较A组好（P〈0．05）。治疗后3个月时视网膜静脉充盈时间均缩短，A组时间差为（4．72±1．08）s，B组为（5．70±1．32）8，C组为（5．24±1．39）s，B组与A组相比，差异有统计学意义（P=0．012）。各组视野平均缺损值较治疗前均有降低，A组视野缺损度治疗前后差值为6．16±1．91，B组为7．81±1．49，C组为6．59±1．70，B组较A组差值大（P=0．002）、B组较c组差值大（P=0．023），差异有统计学意义。结论对于非缺血型CRVO患者，局部光凝可促进视网膜水肿及出血的吸收，有利于视力的恢复且并发症少。

Objective To observe the clinical efficacy of partial retinal photocoagnlation in the treatment of nonischemic central retinal vein occlusion （CRVO）. Methods A total of 65 eyes of 65 cases with nonischemic CRVO were divided randomly into 3 groups. In group A, 22 cases were treated with oral drugs. In group B, 23 cases were treated with the same oral drugs combined with partial retinal photocoagulation. In group C,20 cases were treated with the same oral drugs combined with light panretinal photocoagulation （PRP）. Macular focal/grid laser photocoagulation were treated when nencessary in group B and group C. The visual acuity, central visual field and ocular fundus were observed before and 3, 6 months after treatment. Results Six months after treatment, the visual acuity and ocular fundus were improved, those of group B and C were much better than group A （P 〈 0.05）. The vein circulation time 3 months after treatment was decreased. The decreased vein circulation time in group A was （4.72±1.08 ） s, in group B was （5.70±.32） s and in group C was（5.24 ±1.39） s. There were significant differences between group A and group B（P =0.012）. The central visual field damage in each group was decreased. The value of central visual field damage in group A was 6.16±1.91, in group B was 7.81±1.49 and in group C was 6.59±1.70. There were significant differences between group A and B （ P = 0.002）, group B and C （ P = 0. 023 ）. Conclusion Partial retinal photocoagulation is able to promote abating of retinal edema and hemorrhage, so as to improve the visual function of nonischemic CRVO , and with less complications.