中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2013年
1期
18-20
,共3页
徐斌%戴奕娟%梁丽%杨露
徐斌%戴奕娟%樑麗%楊露
서빈%대혁연%량려%양로
糖尿病视网膜病变/治疗%黄斑水肿/治疗%激光凝固术%治疗结果
糖尿病視網膜病變/治療%黃斑水腫/治療%激光凝固術%治療結果
당뇨병시망막병변/치료%황반수종/치료%격광응고술%치료결과
Diabetic retinopathy/therapy%Macular edema/therapy%Laser coagulation%Treatment outcome
目的 比较黄色微脉冲激光与传统格栅样激光光凝(MLG)治疗糖尿病黄斑水肿(DME)的临床疗效.方法 经荧光素眼底血管造影(FFA)及光相干断层扫描(OCT)检查确诊的弥漫性DME患者78例106只眼纳入研究.采用随机数字表法将患者分为微脉冲组和MLG组,分别为39例51只眼、39例55只眼.微脉冲组患者行577 nm黄色微脉冲激光治疗,MLG组行561 nm黄绿光连续波长激光光凝治疗.治疗前后所有患者均行眼底、矫正视力、OCT及微视野检查,检测其矫正视力、黄斑中心视网膜厚度(CMT)及黄斑10°范围内视网膜平均光敏感度(MS).以治疗后6个月为疗效判定时间点,观察患者治疗前后平均矫正视力、平均CMT及平均MS的变化,对比分析治疗前后两组患者平均矫正视力、平均CMT及平均MS差值之间的差异.结果 治疗后6个月,微脉冲组、MLG组平均矫正视力分别为0.45±0.20、0.42±0.20,均较治疗前提高,差异有统计学意义(t=3.404、2.316,P＜0.05).微脉冲组、MLG组组内治疗前后平均矫正视力的差值分别为0.08±0.02、0.06±0.03,两组差值比较,差异无统计学意义(t=0.532,P＞0.05).治疗后6个月,微脉冲组、MLG组平均CMT分别为(323.94±68.30)、(355.85±115.88)μm,均较治疗前降低,差异有统计学意义(t=4.028、2.039,P＜0.05).微脉冲组、MLG组组内治疗前后平均CMT的差值分别为(55.12±13.68)、(22.25±10.92)μm,两组差值比较,差异无统计学意义(t=1.891,P＞0.05).治疗后6个月,微脉冲组、MLG组平均MS分别为(6.63±2.65)、(4.53±1.81) dB;微脉冲组平均MS较治疗前提高,差异有统计学意义(t=3.335,P＜0.05)；MLG组平均MS较治疗前降低,差异也有统计学意义(t=3.589,P＜0.05).微脉冲组、MLG组组内治疗前后平均MS的差值分别为(1.10±0.33)、(-0.91±0.25)dB,两组差值比较,差异有统计学意义(t=4.872,P＜0.05).结论 黄色微脉冲激光和MLG治疗DME均能提高患者视力,降低CMT;但黄色微脉冲激光可提高患者MS,而MLG降低了患者MS.
目的 比較黃色微脈遲激光與傳統格柵樣激光光凝(MLG)治療糖尿病黃斑水腫(DME)的臨床療效.方法 經熒光素眼底血管造影(FFA)及光相榦斷層掃描(OCT)檢查確診的瀰漫性DME患者78例106隻眼納入研究.採用隨機數字錶法將患者分為微脈遲組和MLG組,分彆為39例51隻眼、39例55隻眼.微脈遲組患者行577 nm黃色微脈遲激光治療,MLG組行561 nm黃綠光連續波長激光光凝治療.治療前後所有患者均行眼底、矯正視力、OCT及微視野檢查,檢測其矯正視力、黃斑中心視網膜厚度(CMT)及黃斑10°範圍內視網膜平均光敏感度(MS).以治療後6箇月為療效判定時間點,觀察患者治療前後平均矯正視力、平均CMT及平均MS的變化,對比分析治療前後兩組患者平均矯正視力、平均CMT及平均MS差值之間的差異.結果 治療後6箇月,微脈遲組、MLG組平均矯正視力分彆為0.45±0.20、0.42±0.20,均較治療前提高,差異有統計學意義(t=3.404、2.316,P＜0.05).微脈遲組、MLG組組內治療前後平均矯正視力的差值分彆為0.08±0.02、0.06±0.03,兩組差值比較,差異無統計學意義(t=0.532,P＞0.05).治療後6箇月,微脈遲組、MLG組平均CMT分彆為(323.94±68.30)、(355.85±115.88)μm,均較治療前降低,差異有統計學意義(t=4.028、2.039,P＜0.05).微脈遲組、MLG組組內治療前後平均CMT的差值分彆為(55.12±13.68)、(22.25±10.92)μm,兩組差值比較,差異無統計學意義(t=1.891,P＞0.05).治療後6箇月,微脈遲組、MLG組平均MS分彆為(6.63±2.65)、(4.53±1.81) dB;微脈遲組平均MS較治療前提高,差異有統計學意義(t=3.335,P＜0.05)；MLG組平均MS較治療前降低,差異也有統計學意義(t=3.589,P＜0.05).微脈遲組、MLG組組內治療前後平均MS的差值分彆為(1.10±0.33)、(-0.91±0.25)dB,兩組差值比較,差異有統計學意義(t=4.872,P＜0.05).結論 黃色微脈遲激光和MLG治療DME均能提高患者視力,降低CMT;但黃色微脈遲激光可提高患者MS,而MLG降低瞭患者MS.
목적 비교황색미맥충격광여전통격책양격광광응(MLG)치료당뇨병황반수종(DME)적림상료효.방법 경형광소안저혈관조영(FFA)급광상간단층소묘(OCT)검사학진적미만성DME환자78례106지안납입연구.채용수궤수자표법장환자분위미맥충조화MLG조,분별위39례51지안、39례55지안.미맥충조환자행577 nm황색미맥충격광치료,MLG조행561 nm황록광련속파장격광광응치료.치료전후소유환자균행안저、교정시력、OCT급미시야검사,검측기교정시력、황반중심시망막후도(CMT)급황반10°범위내시망막평균광민감도(MS).이치료후6개월위료효판정시간점,관찰환자치료전후평균교정시력、평균CMT급평균MS적변화,대비분석치료전후량조환자평균교정시력、평균CMT급평균MS차치지간적차이.결과 치료후6개월,미맥충조、MLG조평균교정시력분별위0.45±0.20、0.42±0.20,균교치료전제고,차이유통계학의의(t=3.404、2.316,P＜0.05).미맥충조、MLG조조내치료전후평균교정시력적차치분별위0.08±0.02、0.06±0.03,량조차치비교,차이무통계학의의(t=0.532,P＞0.05).치료후6개월,미맥충조、MLG조평균CMT분별위(323.94±68.30)、(355.85±115.88)μm,균교치료전강저,차이유통계학의의(t=4.028、2.039,P＜0.05).미맥충조、MLG조조내치료전후평균CMT적차치분별위(55.12±13.68)、(22.25±10.92)μm,량조차치비교,차이무통계학의의(t=1.891,P＞0.05).치료후6개월,미맥충조、MLG조평균MS분별위(6.63±2.65)、(4.53±1.81) dB;미맥충조평균MS교치료전제고,차이유통계학의의(t=3.335,P＜0.05)；MLG조평균MS교치료전강저,차이야유통계학의의(t=3.589,P＜0.05).미맥충조、MLG조조내치료전후평균MS적차치분별위(1.10±0.33)、(-0.91±0.25)dB,량조차치비교,차이유통계학의의(t=4.872,P＜0.05).결론 황색미맥충격광화MLG치료DME균능제고환자시력,강저CMT;단황색미맥충격광가제고환자MS,이MLG강저료환자MS.
Objective To compare the clinical results of yellow micro-pulse laser and traditional laser grid (MLG) photocoagulation for diabetic macular edema (DME).Methods Seventy-eight patients (106 eyes) with DME diagnosed by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were enrolled in this study.The patients were divided into micro-pulse group (39 patients,51 eyes)and MLG group (39 patients,55 eyes).The patients of micro-pulse group underwent 577 nm yellow micropulse laser therapy,while the patients of MLG group underwent continuous wavelength laser photocoagulation with a 561 nm yellow green laser.All the patients were examined documenting corrected visual acuity,macular retinal thickness (CMT) and mean sensitivity within macular 10 ° examination before and after treatment.Six months after treatment was considered as the judgment time for the therapeutic effects.The mean corrected visual acuity,CMT and MS were comparatively analyzed.Results Six months after treatment,the mean corrected visual acuity of micro-pulse group and MLG group were 0.45±0.20 and 0.42±0.20,which increased significantly compared to those before treatment (t=3.404,2.316; P＜0.05).The difference of mean corrected visual acuity between before and after treatment of micro-pulse group and MLG group were 0.08 ± 0.02 and 0.06 ± 0.03,the difference was statistically significant between two groups (t=0.532,P＞0.05).The mean CMT of micro-pulse group and MLG group were (323.94 ± 68.30) and (355.85±115.88) μm,which decreased significantly compared to those before treatment (t=4.028,2.039; P＜0.05).The difference of mean CMT between before and after treatment of micro-pulse group and MLG group were (55.12±13.68) and (22.25±10.92) μm.The difference was not statistically significant between two groups (t=1.891,P＞0.05).The mean MS of micro-pulse group and MLG group were (6.63 ± 2.65) and (4.53 ± 1.81) dB.The mean MS of micro-pulse group increased significantly compared to that before treatment (t =3.335,P ＜ 0.05).The mean MS of MLG group decreased significantly compared to that before treatment (t=3.589,P＜0.05).The difference of mean MS between before and after treatment of micro-pulse group and MLG group were (1.10 ± 0.33) and (-0.91 ±0.25) dB.The difference was statistically significant between groups (t =4.872,P＜0.05).Conclusions In the treatment of DME,yellow micro-pulse laser therapy and MLG can improve visual acuity,and reduce CMT.In addition,yellow micro-pulse laser therapy can improve the MS,but MLG reduces MS.
