视网膜黄斑分支静脉阻塞的激光光凝治疗

Krypton laser photocoagulation of macular branch retinal vein occlusion

目的 观察视网膜黄斑分支静脉阻塞 (macular branch retinal occlusion,MBRVO)眼视网膜激光光凝和非光凝治疗对视力和黄斑水肿吸收的影响以及激光光凝眼光凝治疗前后黄斑光敏感度的变化。 方法 将 4 5例 MBRVO合并黄斑水肿患者的 4 5只患眼随机分为激光光凝治疗组和非光凝治疗组 ,激光光凝治疗组采用氪激光治疗 ,非光凝治疗组采用药物治疗。随访 6个月 ,比较两组患者视力、黄斑水肿改善方面的差异。激光光凝治疗组同时对激光光凝治疗眼治疗前 1周和治疗后 3个月的中心 30°视野光敏感度进行检查 ,比较中心凹、中心 10°、旁中心 11～ 30°激光光凝治疗前后光敏感度的差异。 结果 激光光凝治疗组光凝治疗前平均视力为 0 .32± 0 .2 6 ,光凝治疗 3、6个月后平均视力分别为 0 .5 6± 0 .2 6和 0 .6 3± 0 .2 7;光凝治疗后 6个月83%的患眼黄斑水肿好转 (2 0 /2 4 )。非光凝治疗组首诊时平均视力为 0 .31± 0 .18,随访 3、6个月后平均视力分别为 0 .4 3± 0 .19和 0 .5 5± 0 .2 4 ;随访 6个月后 4 7%的患眼黄斑水肿好转 (10 /2 1)。激光光凝治疗组与非光凝治疗组在视力恢复和黄斑水肿消退方面差异有显著性的意义 (P<0 .0 5 )。激光光凝治疗前和光凝治疗后 3个月黄斑中心凹和旁中心 11～

Objective The present study focus on the macular branch retinal vein occlusion (MBRVO) with and without laser treatment,and evaluate prospectively whether laser treatment is useful in improving the visual acuity and reducing the macular edema. At the same time to learn the difference of macular light sensitivity before and after laser treatment. Methods Forty five eyes of forty five patients with MBRVO and macular edema were randomized to laser treatment and no laser treatment. Follow up examinations were performed every 3 months. We compared the difference of visual improvement, resolution of macular edema between the two groups. The central 30° visual field of 20 patients with MBRVO were examined at pretreatment and 3 months after laser treatment. A comparison of light sensitivity at fovea ,central 10° and 11~ 30° eccentricity were done between before and after laser treatment. Results Comparison of visual improvement and resolution of macular edema showed a statistical difference between laser treatment and no laser treatment. The mean reduction of macular light sensitivity at the fovea and 11~30° 3 months after the treatment has no statistical difference between before and after treatment (P>0.05). But the mean light sensitivity at central 10° eccentricity were significantly decreased 3 months after photocoagulation (P<0.05). Conclusion The laser treatment might promote or accelerate visual acuity recovery and reduce the macular edema. There is no significant difference about the efficiency on macular function after laser treatment.