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目的观察家族性渗出性玻璃体视网膜病变(FEVR)激光光凝和玻璃体视网膜手术治疗的疗效。方法回顾性分析1997年1月至2005年8月期间临床诊断的FEVR患者17例32只眼的临床资料。根据患眼病变轻重程度不同选择治疗方法,其中7只眼(1期2只眼、2A期1只眼和2B期4只眼)采用周边视网膜激光光凝治疗,治疗后随访6~108个月,平均随访时间30.29个月。13只眼(3B期2只眼、4A期1只眼、4B期6只眼和5A期4只眼)采用玻璃体视网膜手术治疗,手术后随访3~72个月,平均随访时间23.19个月;另外12只眼因病变太严重、年龄及家属选择等原因未接受治疗。结果接受激光光凝治疗的7只眼随访期间病情稳定,视力保持不变。接受玻璃体视网膜手术治疗的13只眼,除1只眼外12只眼黄斑区均达到解剖复位。9只眼手术后视力提高,3只眼手术后视力保持不变,1只眼视力检查不合作。结论激光光凝能控制FEVR病情发展;玻璃体视网膜手术有利于促进FEVR患者视网膜复位和提高视力。两种治疗方法是治疗FEVR的有效手段。
Objective To observe the curative effect of familial exudative vitreoretinopathy (FEVR) laser photocoagulation and vitreoretinal surgery. Methods The clinical data of 17 eyes of 32 patients with FEVR clinically diagnosed between January 1997 and August 2005 were retrospectively analyzed. According to the severity of the affected eye, the treatment methods were selected according to the degree of severity of the lesion. Seven eyes (1 in 2 eyes, 1 in 2A and 4 in 2B) were treated with peripheral retinal laser photocoagulation and were followed up for 6 to 108 months , The average follow-up time was 30.29 months. Thirteen eyes (3 eyes of 3B, 1 eyes of 4A, 6 eyes of 4B and 4 eyes of 5A) were treated by vitreoretinal surgery. The follow-up was from 3 to 72 months and the average follow-up time was 23.19 months. The other 12 eyes due to serious disease, age and family members did not receive treatment for reasons such as choice. Results Seven eyes treated with laser photocoagulation were stable during the follow-up period and the visual acuity remained unchanged. Thirteen eyes undergoing vitreoretinal surgery achieved anatomical reduction in all macular areas except 12 eyes. Visual acuity improved after operation in 9 eyes, visual acuity remained unchanged in 3 eyes and uncooperative in 1 eye. Conclusion Laser photocoagulation can control the development of FEVR. Vitreoretinal surgery is helpful to promote retina reattachment and improve vision in FEVR patients. Both treatments are effective treatments for FEVR.