糖尿病视网膜病变患者全视网膜激光光凝前后视网膜动、静脉循环时间的改变

Changes of retinal circulation time before and after panretinal laser photocoagulation in patients with diabetic retinopathy

目的观察糖尿病视网膜病变(diabetic retinopathy,DR)患者全视网膜激光光凝(pan-retinal laser photocoagulation,PRP)治疗前后视网膜动、静脉循环时间的改变。方法经荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查确诊为重度非增殖期及增殖期DR且符合PRP适应证的16例(16眼)患者纳入研究,并行PRP。治疗前、治疗后1~3个月,采用FFA对所有患眼视网膜动、静脉循环时间进行记录,观察视网膜动脉4个分支主干出现显影的时间、完全充盈的时间,视网膜静脉4个分支主干全部出现层流的时间、完全充盈的时间,计算得出视网膜动脉、视网膜毛细血管、视网膜静脉、视网膜动静脉通过时间,对比观察治疗前后患眼不同时段的视网膜通过时间的变化。结果 DR患者PRP治疗前视网膜毛细血管通过时间为(1.58±0.99)s,治疗后为(2.19±1.23)s,差异有统计学意义(P=0.011)。DR患者PRP治疗前后的视网膜动脉、视网膜静脉、视网膜动静脉通过时间的差异均无统计学意义(均为P>0.05)。结论 PRP是DR患者的最重要治疗方式,在PRP治疗后1~3个月视网膜毛细血管通过时间的血流动力学改变最为显著,较PRP治疗前有显著延长。

Objective To observe the changes of preoperative and postoperative retinal circulation time in panretinal laser photocoagulation （PRP） in patients with dia- betic retinopathy （DR）. Methods Together 16 patients （ 16 eyes） were collected as the subjects in this study,who was diagnosed as severe non-proliferative and prolifera- tive DR by fundus fluorescein angiography （FFA） examination and had PRP indications for undergoing pan-retinal laser photocoagulation. Then retinal arterial and venous cir- culation time in all patients was recorded using FFA before and 1 to 3 months after treatment. Meanwhile, it was necessary to observe the following variables, including the developing duration and complete filling time of the four branches of the retinal artery, as well as the duration of the laminar flow and complete filling time of the four bran- ches of the venous artery, followed by calculating mean transition time of retinal artery, retinal capillary, retinal vein, retinal arteriovenous flow for comparison and analysis of changes in transit time of retina ± 0.99 ） s before treatment and （2.19 ± 1.23 ）s after treatment, and the difference was statistically significant（P= 0. 011 ）, but there was no significant difference in the mean transition time of the retinal artery, retinal vein and arteriovenous flow （ all P 〉 0.05 ）. Conclu- sion The transit time of the retinal capillary at 1 to 3 months after PRP is significantly longer than that before treatment.