眼底激光疗法对糖尿病视网膜病变黄斑水肿的应用研究

Application of fundus laser therapy on macular edema in diabetes retinopathy

目的:观察眼底激光疗法对糖尿病视网膜病变(DR)黄斑水肿的治疗效果。方法:本研究为前瞻性研究,选择河南大学第一附属医院2022年8月—2023年8月收治的120例DR患者为研究对象,采用计算机随机数字表法分为激光组(60例)和联合组(60例),激光组予以眼底激光疗法治疗,联合组采用雷珠单抗联合眼底激光疗法治疗。比较2组患者住院时间、出血吸收时间、黄斑水肿消散时间、渗出吸收时间,黄斑中心凹厚度、黄斑区视网膜厚度、眼压最佳矫正视力及并发症发生情况。结果:联合组住院时间、出血吸收时间、黄斑水肿消散时间、渗出吸收时间[(1.35±0.46)周、(2.25±0.34)周、(4.22±1.36)周、(10.24±2.25)周]均低于激光组[(2.14±0.76)周、(2.88±0.82)周、(5.41±1.75)周、(12.33±3.14)周](P<0.05);联合组治疗1、3个月后的黄斑中心凹厚度[(331.25±20.61)μm、(251.22±20.46)μm]均低于激光组[(345.25±20.52)μm、(265.25±20.41)μm](P<0.05),黄斑区视网膜厚度[(324.33±20.65)μm、(241.54±20.37)μm]均低于激光组[(340.45±20.72)μm、(255.36±20.73)μm](P<0.05);联合组治疗1、3个月后的眼压[(15.44±3.46)mmHg、(12.49±3.61)mmHg]均低于激光组[(18.76±4.27)mmHg、(15.36±3.77)mmHg](P<0.05),最佳矫正视力[(0.66±0.19)、(0.81±0.25)]均高于激光组[(0.48±0.16)、(0.59±0.21)](P<0.05);联合组的并发症发生率(6.67%)低于激光组(20.00%),差异有统计学意义(P<0.05)。结论:眼底激光疗法联合雷珠单抗能加快DR患者康复进程,对改善视网膜结构参数及降低并发症发生风险均有积极意义。

Objective:To observe the therapeutic effect of fundus laser therapy on macular edema in diabetes retinopathy(DR).Methods:This study is a prospective study,selecting 120 DR patients admitted to the First Affiliated Hospital of Henan University from August 2022 to August 2023 as the study subjects.They were randomly assigned to the laser group(60 cases)and the combination group(60 cases)using a computer random number table method.The laser group received fundus laser therapy,while the combination group received ranibizumab combined with fundus laser therapy.The hospital stay and bleeding absorption time of the two groups of patients were compared The time for macular edema to dissipate,the time for exudate absorption,the thickness of the macular fovea,the thickness of the macular retina,the best corrected visual acuity for intraocular pressure,and the incidence of complications.Results:Under different treatment plans,the hospitalization time,bleeding absorption time,macular edema dissipation time,and exudate absorption time of the combined group were(1.35±0.46)weeks,(2.25±0.34)weeks,(4.22±1.36)weeks,and(10.24±2.25)weeks,lower than the laser group[(2.14±0.76)weeks,(2.88±0.82)weeks,(5.41±1.75)weeks,and(12.33±3.14)weeks];The thickness of the macular fovea after 1 month and 3 months of combined treatment were(331.25±20.61)μm.(251.22±20.46)μm.,lower than the laser group[(345.25±20.52)μm,(265.25±20.41)μm]The retinal thickness in the macular area were(324.33±20.65)μm.,(241.54±20.37)μm,lower than the laser group[(340.45±20.72)μm,(255.36±20.73)μm];After 1 month and 3 months of treatment,the intraocular pressure in the combination group were(15.44±3.46)mmHg and(12.49±3.61)mmHg,lower than those in the laser group[(18.76±4.27)mmHg and(15.36±3.77)mmHg].The best corrected visual acuity was(0.66±0.19)and(0.81±0.25),higher than the laser group[(0.48±0.16)and(0.59±0.21)];The incidence of complications in the combined group was 6.67%(4/60)lower than the laser group 20.00%(12/60)(P<0.05).Conclusion:The combination of fundus laser therapy and ranibizumab can accelerate the rehabilitation process of DR patients,improve retinal structural parameters,and reduce the risk of complications.