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目的:探讨重复应用全视网膜光凝治疗糖尿病视网膜病变的指征。方法:糖尿病视网膜病变患者122例(212眼),78例(126眼)为非增生期,44例(86眼)为增生期。采用ND-YAG氩绿激光(波长530nm)进行全视网膜光凝,治疗分3~4期进行。术后24~36mo随访,评价视力变化、视网膜病变进展和视网膜新生血管消退情况。结果:治疗后视力(0.3的患者量明显小于治疗前,继续下降比率明显减少;全视网膜光凝术后3,12,24mo和36mo视网膜病变稳定率分别为73.6%,80.0%,84.0%,85.4%;新生血管消退分别达到38.6%,56.2%,73.6%,81.4%,治疗后视网膜新生血管逐渐减少。结论:如果存在严重视网膜缺氧征象,即出现小动脉瘤、微小出血点积聚、严重的视网膜内微血管异常和小静脉明显形成时,可多次重复应用全视网膜光凝治疗糖尿病视网膜病变。
Objective: To investigate the indications of repeated application of panretinal photocoagulation in the treatment of diabetic retinopathy. Methods: 122 patients with diabetic retinopathy (212 eyes), 78 (126 eyes) were non proliferative and 44 (86 eyes) were proliferative. The use of ND-YAG Argon laser (wavelength 530nm) for panretinal photocoagulation, the treatment is divided into 3 to 4 phases. The patients were followed up 24 to 36 months after surgery to evaluate the changes of visual acuity, the progress of retinopathy and the retina neovascularization. Results: The visual acuity (0.3) after treatment was significantly lower than that before treatment, and the rate of continuous decline was significantly decreased. The stability rates of retinopathy at 3, 12, 24 and 36 months after panretinal photocoagulation were 73.6%, 80.0%, 84.0% and 85.4 %, And neovascularization respectively reached 38.6%, 56.2%, 73.6% and 81.4% respectively.Conclusion: If there is serious signs of retinal hypoxia, small aneurysms and micro-hemorrhagic spots accumulate, severe Retinal microvascular abnormalities and the formation of small veins can be repeated multiple applications of retinal photocoagulation in the treatment of diabetic retinopathy.