轻型播散性光凝治疗中度非增殖期糖尿病视网膜病变

Mild form disseminated photocoagulation treatment for moderate non-proliferative diabetic retinopathy

摘要:

目的：观察轻型播散性光凝治疗中度非增殖性糖尿病视网膜病变的临床疗效。

方法：前瞻性随机对照研究。选取2010-06/2014-06在杨浦区市东医院眼科门诊就诊的中度非增殖期糖尿病视网膜病变患者126例209眼，随机分为治疗组62例103眼，对照组64例106眼。治疗组行轻型播散性光凝，对照组单纯内科治疗控制血糖。随访24mo，观察比较两组最佳矫正视力、眼底改变及中心视野变化。

结果：治疗后24mo，治疗组与对照组相比，治疗组患眼最佳矫正视力提高者或稳定者更多，两组差异有统计学意义(H_c=5.942，P<0.05)。治疗组眼底体征好转及稳定者更多，两组差异有统计学意义(H_c=12.662，P<0.05)。治疗组治疗前，治疗后12mo视野平均MS差异无统计学意义(t=3.1586，P>0.05)。至末次随访未出现感染、视网膜出血、视网膜前膜、误伤中心凹等并发症。

结论：轻型播散性光凝治疗中度非增殖性糖尿病视网膜病变安全有效，无明显并发症，可有效延缓糖尿病视网膜病变的进展。

Abstract:

AIM:To observe the therapeutic effect of the mild form disseminated photocoagulation treatment for moderate non-proliferative diabetic retinopathy(MNPDR).

METHODS: Prospective randomized controlled study. Totally 126 cases(209 eyes)with MNPDR were randomly assigned to two groups in ophthalmology department of Shanghai Shidong Hospital. There were 62 cases(103 eyes)were treated with the mild form disseminated photocoagulation as the therapy group, 64 cases(106 eyes)were treated with control of blood glucose as the control group. All cases were followed up for 24mo. The best corrected visual acuity(BCVA), fundus change and central visual field were observed and compared.

RESULTS: At 24mo after treatment, BCVA variety between two groups took on significant statistical difference which indicated that there were more eyes with improved or stable visual acuity in therapy group(H_c=5.942, P<0.05). There was significant difference in fundus examination between two groups which indicated that there were more eyes with improved or stable fundus change in therapy group(H_c=12.662, P<0.05). There was no significant difference in average mean sensitivity(MS)between before and after laser therapy for 12mo(t=3.1586, P>0.05). During our follow-up, there were no complications likewise infection, hemorrhage, retinal membrane, injury of the macular fovear occurred.

CONCLUSION: The mild form disseminated photocoagulation therapy for moderate non-proliferative diabetic retinopathy is safe and effective without obvious complications, which can effectively delay the progression of diabetic retinopathy.