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目的评价532nm激光全视网膜光凝(panretinal photocoagulation,PRP)治疗增殖前期(preproliferative diabetic retinopathy,PPDR)和增殖期糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的疗效。方法采用532nm激光对125例236只眼PPDR和PDR患者行PRP,比较治疗前后视力、眼底及荧光素眼底血管造影(fundus fluorescein angiography,FFA)变化。结果一次和追加光凝后,PPDR组52只眼视力提高或无变化,占78.8%;14只眼视力下降,占21.2%。PDR组121只眼视力提高或无变化,占71.2%;49只眼视力下降,占28.8%。一次和追加光凝后,PPDR组眼底病变改善63眼,有效率95.5%,有3眼(4.5%)进展为PDR;PDR组改善154眼,有效率90.6%,仍有12眼(7.1%)行玻璃体切割术,4眼(2.3%)因新生血管性青光眼行睫状体冷凝术。结论 532nm激光PRP治疗PPDR和PDR有较好疗效。
Objective To evaluate the efficacy of 532 nm laser panretinal photocoagulation (PRP) in the treatment of preproliferative diabetic retinopathy (PPDR) and proliferative diabetic retinopathy (PDR). Methods PRP was performed in 125 patients with PPDR and PDR in 125 eyes using 532nm laser. The changes of visual acuity, fundus and fundus fluorescein angiography (FFA) before and after treatment were compared. Results After primary and additional photocoagulation, the visual acuity of 52 eyes in PPDR group increased or remained unchanged, accounting for 78.8%. The visual acuity decreased in 14 eyes (21.2%). In 121 eyes of PDR group, the visual acuity increased or no change, accounting for 71.2%; 49 eyes visual acuity decreased, accounting for 28.8%. One time and additional photocoagulation, 63 eyes were improved in PPDR group, the effective rate was 95.5%, and the progression of PDR was PDR in 154 eyes (90.6%, 12 eyes, 7.1%) In vitrectomy, 4 eyes (2.3%) underwent ciliary body condensation due to neovascular glaucoma. Conclusions The 532nm laser PRP is effective in treating PPDR and PDR.