目的:观察增殖型糖尿病性视网膜病变(proliferativediabetic retinopathy,PDR)行全视网膜光凝术(panretinalphotocoagulation,PRP)后5a的疗效及预后分析。方法:对92例149眼PDR患者行PRP治疗后的1,3,6,12mo进行复查,以后每6mo进行复查,并在3mo后均复查FFA,必要时补充光凝,随访5a。结果:视力提高52眼,保持不变71眼,下降26眼。5a后患者的最终矫正视力情况:≤0.01者19眼,～0.1者64眼,～0.5者58眼,>0.5者8眼。在激光后的随访期间血糖水平基本控制在正常范围内的63眼中,5a后只有6眼发生玻璃体积血、牵拉性视网膜脱离等严重并发症,占9.5%,而在血糖水平控制不满意的29眼中,有9眼(31%)发生上述情况。结论:通过早期发现、及时治疗和定期随访观察而减少糖尿病性盲是完全可能的。对于PDR患者,确诊后应立即进行PRP治疗,并制定定期随访计划,必要时应复查FFA或补充激光,同时,要向患者阐明,严格正规的内科治疗,将血糖控制在正常范围内,可有效地降低或延缓PDR发展的倾向。

AIM:To observe the effect and prognosis in patients with proliferative diabetic retinopathy(PDR) five years after panretinal photocoagulation(PRP).METHODS:Totally 92 cases(149 eyes) with PDR were reviewed one month,three months,six months,one year and then half-yearly after PRP treatment,and reviewed FFA after three months,if necessary,added photocoagulation.All patients were reviewed for the statistics and the conclusion.RESULTS:Visual acuity improved in 52 eyes,unchanged in 71 eyes,decreased in 26 eyes.So far,the final corrected visual acuity after PRP:19 eyes was≤0.01,64 eyes between>0.01-0.1,58 eyes between>0.1-0.5,8 eyes>0.5.During the follow-up after laser blood glucose level was controlled within the normal range in 63 eyes,five years later only six eyes were complicated with vitreous hemorrhage,tractive retinal detachment and other serious complications,accounting for 9.5%,while in 29 eyes of unsatisfied blood glucose levels,9 eyes(31%) occurred with above situation.CONCLUSION:The early detection and timely treatment and regular follow-up observations to reduce diabetic blindness is entirely possible.For the PDR patients,immediately PRP treatment after diagnosed and to develop regular follow-up plan,and as necessary,to review the FFA or additional laser should be conducted.At the same time,that formal medical treatment and satisfied blood glucose control can effectively reduce or delay the development of PDR should be clarified to the patient.