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目的探讨掺钕钇铝石榴石(Nd:YAG)激光击栓术治疗视网膜分支动脉阻塞的临床效果。方法选择视网膜分支动脉阻塞的患者进行Nd:YAG激光治疗。治疗前检查视力和眼底,确定动脉栓子的部位并行眼底照相。治疗后立即进行眼底照相,并与治疗前图像对比分析,之后定期复查。随访时间为2周至4个月,平均1.6个月。结果共治疗7例患者,其中男性5例,女性2例;年龄为49~73岁,平均61岁;病程为1 d至2个月,平均13 d。治疗前视力为0.06至0.8;眼底可见典型的分支动脉阻塞表现。所有患者治疗后动脉管径均立即增粗,荧光素眼底血管造影检查显示血流完全恢复,患者自觉视力改善,检查视力为0.2~1.0。多数患者视野检查显示在相应的动脉分布范围内仍有视野缺损区。在治疗过程中,偶见局部小出血,仅2例患者术中因击破邻近静脉引起玻璃体积血,观察2周后,逐渐吸收。未见其他并发症。结论Nd:YAG激光击栓术是治疗视网膜分支动脉阻塞的有效方法,见效快且相对安全。
Objective To investigate the clinical effect of neodymium-doped yttrium aluminum garnet (Nd: YAG) laser hitting technique on retinal branch artery occlusion. Methods Nd: YAG laser was used in patients with retinal artery occlusion. Visual acuity and fundus examination before treatment to determine the location of arterial emboli parallel fundus photography. Fundus photography was performed immediately after treatment, and compared with pre-treatment images, followed by regular review. Follow-up time was 2 weeks to 4 months, an average of 1.6 months. Results A total of 7 patients were treated, including 5 males and 2 females. The age ranged from 49 to 73 years with an average of 61 years. The course of disease ranged from 1 d to 2 months with an average of 13 days. Visual acuity before treatment ranged from 0.06 to 0.8; typical branch artery occlusion manifested in the fundus. All patients with arterial diameter immediately after treatment thickening, fundus fluorescein angiography showed complete recovery of blood flow, patients with improved visual acuity, visual acuity of 0.2 to 1.0. Most patients visual field examination showed that there is still visual field defect in the corresponding range of artery distribution. Occasionally in the course of treatment, local bleeding, only 2 patients due to break the adjacent vein caused by vitreous hemorrhage, observed after 2 weeks, gradually absorbed. No other complications. Conclusion Nd: YAG laser thrombectomy is an effective method for the treatment of branch retinal artery occlusion. It is effective and relatively safe.