激光诱导脉络膜视网膜静脉吻合术 治疗视网膜静脉阻塞

目的观察激光诱导脉络膜视网膜静脉吻合术治疗视网膜静脉阻塞（retinal vein occlusion， RVO）的临床疗效。方法RVO患者28例28只眼，其中非缺血型组18例18只眼，采用氪红激光诱导脉络膜视 网膜静脉吻合；缺血型组10例10只眼，氪红激光诱导脉络膜视网膜静脉吻合的同时行激光格 子样或播散性光凝。术后每1～2周复查1次视力、眼底，术后2～3个月复查荧光素眼底血管造影（fundus fluorescein angiography， FFA)，随访5个月以上。结果18只非缺血型RVO眼中有7只眼形成脉络膜视网膜静脉吻合，占 38.9%，7只眼最佳矫正视力提高（4.43±0.78）行，未建立吻合的11只眼最佳矫正视力降低（0.19±0.67）行，二者比较差异有显著性意义（P<0.001）。随访时间内，未建立吻合的11只眼中有4只眼发展为缺血状态，占36.4%。10只缺血型R VO眼中有2只眼形成脉络膜视网膜静脉吻合，占20.0%，视力提高6行；未形成吻合者，治疗前后视力没有改变(P>0.05)。结论激光诱导脉络膜视网膜静脉吻合术是治疗 RVO的一种新的有效疗法，尤其适用于非缺血型 RVO患者，成功的吻合可防止其发展至缺血状态。(中华眼底病杂志,2001,17:8-11)

Laser-induced chorioretinal venous anastomosis for retinal vein occlusion

Purpose　To evaluate the therapeutic effect of laser-induced chorioretinal venous anastomosis for retinal vein occlusion　(RVO)．　Methods　The investigation included 28 consecutive patients　(28 eyes) with RVO．The non-ischemic group 18　cases　(18 eyes) were treated with the krypton red laser to induce chorioretinal venous anastomosis， the ischemic group underwent the same therapy and the grid or scatter-type photocoagulation at the same time． All of the eyes were followed up for more than 5 months， and with an average period of 6．6 months．　Results　Seven cases　(7 eyes， 38．9%) of the non-ischemic group created successful chorioretinal venous anastomosis， with mean improvement of 4．43±0．78　standard deviation　（±s） lines of best-corrected visual acuity compared to　0．19±0．67　（±s） lines for 11 eyes with unsuccessful anastomosis　(P<0．001)． None of the seven eyes developed to ischemic state． Four of the 11 eyes with unsuccessful anastomosis converted to ischemic type (36．4%)． Two cases of the ischemic group created successful anastomosis with improvement in visual acuity． The other cases had no change in visual acuity．　Conclusion　Laser-induced chorioretinal venous anastomosis is a new therapeutic method for RVO， especially for nonischemic type　and successful anastomosis can decrease the conversion rate of the vein occlusion to an ischemic state．