摘要
目的 观察不同分期糖尿病视网膜病变 (DR)全视网膜光凝的疗效及预后分析。方法 根据DRPS (DiabeticRetinopathyPhotocoagulationstudyGroup)制订的治疗技术规定 ,对 2 90例43 8眼分别为增殖前期糖尿病视网膜病变 (PPDR)、增殖期糖尿病视网膜病变 (PDR)行全视网膜光凝治疗 ,按技术规定的光凝范围和光凝参数行次全全网膜光凝 (Sub -PRP)、标准全网膜光凝 (S -PRP)和超全网膜光凝 (E -PRP) ,术后 3个月 ,6个月 ,12个月行FFA及彩色眼底像 ,新生血管未消退者和无灌注区尚存者追加光凝 ,随访 3～ 48个月。结果 PPDR视力提高和不变占 75眼(78 1% ) ,早期PDR视力提高和不变占 15 3眼 (81 8% ) ,而高危PDR视力提高和不变占 10 4眼(67 1% )。经过一次全网膜光凝后 ,PPDR有效率为 89眼 (92 7% ) ,早期PDR有效率为 170眼(90 9% ) ,高危PDR有效率为 73眼 (4 7 1% )。 3月后复查FFANV未退 ,NP未消失者可以追加光凝 ,PPDR追加光凝 17(17 7% )眼 ,但仍有 10 (10 4% )眼进展为PDR ;PDR一次或多次追加光凝 93 (4 9 7% )眼 ,最终仍有 4(2 14 % )眼行玻璃体切割术 ;高危PDR一次或多次追加光凝 13 8(89 0 % )眼 ,但最终有 3 3 (2 1 3 % )眼行玻璃体切割术 ,8(5 16% )眼因新生血管性青光眼行视网膜或睫状体冷冻术。结?
Objective To observe the effects of panretinal photocoagulation for diabetic retinopathy of different staging and prognosis analysis.Methods According to the treatment technique stipulations formulated by DRPSG(Diabetic Retinopathy Photocoagulation study Group),438 eyes in 290 cases respectively suffering from preproliferrative diabetic retinopathy(PPDR),proliferative diabetic retinopathy(PDR)were treated with panretinal photocoagulation.These patients were received the treatment of subpanretinal photocoagulation(Sub-PRP),standard panretinal photocoagulation(S-PRP)and extra panretinal photocoagulation(E-PRP).All these treatment were performed with the range and parameters provided by the treatment technique stipulations.The Fundus Fluorescein Angiography(FFA)and color photograph were taken 3m,6m and 12m after the treatment.For those cases with remaining new vessels and non-perfusion areas,the treatment was complemented with further photocoagulation.The follow-up period was 3～48 months.Results Visual acuity were improved or maintained in 75 eyes(78 1%)in group of PPDR,153 eyes(81 8%)in group of early PDR,104 eyes(67 1%)in group of high risk PDR.After one time panretinal photocoagulation,the effective rate was 89 eyes(92 7%)in group of PPDR,170 eyes(90 9%)in group of early PDR,73 eyes(47 1%)in group of high risk PDR.For those cases with remaining new vessels and non-perfusion areas,the treatment was complemented with further photocoagulation in 3m after the first treatment.The cases with further photocoagulation were 17 eyes(17 7%)in group of PPDR,but there were 10 eyes(10 4%)to develop to PDR.The cases with further photocoagulation were 93 eyes(49 7%)in group of PDR,there were 4 eyes(2 14%)to underwent vitrectomy.The cases with further photocoagulation were 138 eyes(89 0%)in group of high risk PDR,there were 33 eyes(21 3%)to underwent vitrectomy,8 eyes to underwent cryotherapy due to neovasculer glaucoma.Conclusions The prognosis of diabetic retinopathy of different staging is different after panreteinal photocoagulation.It′s very important to choice suitable occasion and reasonable parameters for panretinal photocoagulation for patients with diabetic retinopathy to ensure visual acuity maintaining.
出处
《中国实用眼科杂志》
CSCD
北大核心
2004年第10期801-803,共3页
Chinese Journal of Practical Ophthalmology
