中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2015年
1期
8-11
,共4页
视网膜中央静脉阻塞,缺血型%全视网膜光凝%虹膜新生血管
視網膜中央靜脈阻塞,缺血型%全視網膜光凝%虹膜新生血管
시망막중앙정맥조새,결혈형%전시망막광응%홍막신생혈관
central retinal vein occlusion,ischemic%panretinal photocoagulation%iris neovascularization
目的：评价全视网膜光凝（PRP）治疗对不同阶段缺血型视网膜中央静脉阻塞（CRVO）的疗效。方法2011年6月至2014年4月来上海交通大学医学院附属仁济医院眼科门诊通过视功能、裂隙灯、扩瞳眼底及眼底荧光血管造影（FFA）检查诊断为缺血型CRVO的患者，根据激光治疗时是否存在虹膜新生血管（INV）将患者分为无INV的A组（34眼）和已出现INV的B组（7眼）。所有患者均接受PRP治疗，并根据病情变化和FFA的结果在随访中予补充光凝。随访6个月～3年，平均（19.3±8.5）个月，观察PRP在减少和预防缺血型CRVO严重并发症及光凝等方面的差异。结果 A、B两组患者在发病年龄上差异无统计学意义（P＞0.05）。经PRP治疗后， B组患者最终的激光次数和总光凝点数均显著多于A组（P＜0.05）；B组患者新生血管性青光眼（NVG）的发生率较高（P＜0.05），但两组间的玻璃体出血（VH）的发生率差异无统计学意义（P＞0.05）；两组患者在治疗前后的视力差异无统计学意义（P＞0.05）。结论本研究提示缺血型CRVO患者在没有出现INV之前进行PRP，最终严重并发症的发生率相对较低，所需光凝次数和点数均较少。
目的：評價全視網膜光凝（PRP）治療對不同階段缺血型視網膜中央靜脈阻塞（CRVO）的療效。方法2011年6月至2014年4月來上海交通大學醫學院附屬仁濟醫院眼科門診通過視功能、裂隙燈、擴瞳眼底及眼底熒光血管造影（FFA）檢查診斷為缺血型CRVO的患者，根據激光治療時是否存在虹膜新生血管（INV）將患者分為無INV的A組（34眼）和已齣現INV的B組（7眼）。所有患者均接受PRP治療，併根據病情變化和FFA的結果在隨訪中予補充光凝。隨訪6箇月～3年，平均（19.3±8.5）箇月，觀察PRP在減少和預防缺血型CRVO嚴重併髮癥及光凝等方麵的差異。結果 A、B兩組患者在髮病年齡上差異無統計學意義（P＞0.05）。經PRP治療後， B組患者最終的激光次數和總光凝點數均顯著多于A組（P＜0.05）；B組患者新生血管性青光眼（NVG）的髮生率較高（P＜0.05），但兩組間的玻璃體齣血（VH）的髮生率差異無統計學意義（P＞0.05）；兩組患者在治療前後的視力差異無統計學意義（P＞0.05）。結論本研究提示缺血型CRVO患者在沒有齣現INV之前進行PRP，最終嚴重併髮癥的髮生率相對較低，所需光凝次數和點數均較少。
목적：평개전시망막광응（PRP）치료대불동계단결혈형시망막중앙정맥조새（CRVO）적료효。방법2011년6월지2014년4월래상해교통대학의학원부속인제의원안과문진통과시공능、렬극등、확동안저급안저형광혈관조영（FFA）검사진단위결혈형CRVO적환자，근거격광치료시시부존재홍막신생혈관（INV）장환자분위무INV적A조（34안）화이출현INV적B조（7안）。소유환자균접수PRP치료，병근거병정변화화FFA적결과재수방중여보충광응。수방6개월～3년，평균（19.3±8.5）개월，관찰PRP재감소화예방결혈형CRVO엄중병발증급광응등방면적차이。결과 A、B량조환자재발병년령상차이무통계학의의（P＞0.05）。경PRP치료후， B조환자최종적격광차수화총광응점수균현저다우A조（P＜0.05）；B조환자신생혈관성청광안（NVG）적발생솔교고（P＜0.05），단량조간적파리체출혈（VH）적발생솔차이무통계학의의（P＞0.05）；량조환자재치료전후적시력차이무통계학의의（P＞0.05）。결론본연구제시결혈형CRVO환자재몰유출현INV지전진행PRP，최종엄중병발증적발생솔상대교저，소수광응차수화점수균교소。
Objective To evaluate the therapeutic effect of panretinal photocoagulation (PRP) in the treatment of ischemic central retinal vein occlusion (CRVO) at different stages. Methods From June 2011 to April 2014, all the patients with ischemic CRVO diagnosed in our department by visual function, slit-lamp biomicroscopy, funduscopy under dilated pupil and fluorescein angiography were recruited in this study. Before PRP, the cohort was divided into 2 groups according to the existence of iris neovascularization (INV), that is, group A (34 eyes without INV) and group B (7 eyes with INV). All patients received standard PRP treatment in a period of 2 to 3 weeks, and the additional laser treatments were given during the follow-up period based on the results of fundus fluorescein angiography (FFA) or clinical manifestations. They were followed up for 6 months to 3 years [(19.3±8.5) months]. The incidence of severe complications and the times of laser treatment were observed and compared between the 2 groups. Results There was no statistical difference in the term of age of onset between the 2 groups (P>0.05). When PRP finished, the times of laser treatment and the total number of laser spots needed were significantly greater in group B than those in group A (P<0.05). The incidence of neovascular glaucoma (NVG) was obviously higher in group B (P<0.05), but there was no statistical difference in vitreous hemorrhage (VH) between the 2 groups (P>0.05). No significant difference was found in the visual acuity before and after treatment in both groups (P>0.05). Conclusion For ischemic CRVO, the incidence of severe complications is relatively low, and the times of laser treatment and the total number of laser spots are also less when PRP is performed before the occurrence of INV.
