激光治疗视网膜分支静脉阻塞疗效分析

目的:探讨倍频Nd∶YAG532nm激光治疗视网膜分支静脉阻塞的疗效。方法:采用倍频Nd∶YAG532nm激光治疗视网膜分支静脉阻塞49例(49眼),灌注区采用II级光斑反应,无灌注区采用III级光斑反应,黄斑水肿格栅光凝,光凝后3～6mo复查FFA,对有渗漏或新生血管不退者,补充光凝,分析不同类型,不同发病时间激光治疗后视力变化及FFA情况。结果:激光治疗后,缺血型28眼中,视力提高者10眼(36%);不变16眼(57%);视力下降2眼(7%)。非缺血型21眼中,视力提高者18眼(86%),不变3眼(14%)。发病1～3mo与4mo以上激光治疗视力比较,P<0.05,有显著差异。FFA49眼中,43眼(88%)显示渗漏及毛细血管无灌注区消失。结论:激光治疗能促进水肿、出血、渗出的吸收,消灭无灌注区及新生血管,阻止并发症的发生,保护和提高视力,激光治疗早期优于晚期,视力缺血型比非缺血型预后差。

Analysis of the curative effect of laser photocoagulation in treating branch retinal vein occlusion

AIM:To explore the curative effect of Nd:YAG532nm laser photocoagulation in treating branch retinal vein occlusion (BRVO).METHODS:Forty-nine BRVO cases (49 eyes) were treated by Nd:YAG532nm laser photocoagulation.Photo coagulation reaction was controlled at grade Ⅱ in non-perfusion area and at grade Ⅲ in perfusion area.After laser grid photocoagulation in the eyes with macular edema,FFA examination was performed within 3-6 months.For those with leakage or neovascularization was not decrease,further photocoagulation was done.The type,onset time,vision changes after laser treatment and FFA were analyzed.·RESULTS:After laser treatment in 28 ischemic-type eyes,visual acuity in 10 eyes (36%) were improved,16 eyes (57%) not change,and 2 eyes (7%) decreased;in 21 ischemic eyes,visual acuity in 18 eyes (86%) were increased and 3 eyes (14%) unchanged.There was significant difference on the curative effect of laser treatment at 1-3 months and 4 months after onset (P<0.05).After FFA examination in all 49 eyes,43 eyes (88%) showed a disappearance of leakage and neovasculariza-tion without perfusion area.CONCLUSION:Laser treatment can promote absorption of edema,hemorrhage and exudation,eliminate non-perfusion area and neovascularization,avoid of com-plications,prevent and improve visual acuity.The earlier the treatment is done,the better curative effect will get.Visual prognosis in non-ischemic eyes is better than that in ischemic eyes.·