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糖尿病性黄斑水肿的早期诊断与治疗 总被引:1,自引:0,他引:1
糖尿病性视网膜病变( diabetic retinopathy,DR)是50岁以上人群主要致盲眼病之一,而糖尿病性黄斑水肿( diabetic maeular edema, DME)则是DR患者视力下降的首要原因。因此其早诊断、早治疗尤为重要。随着前置镜、OCT、FFA、mfERG等的出现,尤其是视网膜厚度、视网膜体积、水肿指数等客观评价黄斑水肿的量化指标,体现了近年视网膜成像技术的新进展。 OCT是近年临床应用的一种非接触性、非侵入性、高分辨率的眼科影像学检查,可以对视网膜超微结构进行观察并做定量分析,且技术已相对成熟,成为黄斑水肿诊断的常规检查。激光光凝、雷珠单抗玻璃体腔内注射以及玻璃体手术是现今治疗顽固性黄斑水肿的重要手段。 相似文献
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糖尿病性黄斑水肿(diabetic macular edema,DME)是导致糖尿病视网膜病变患者视力下降的主要原因之一,作者对近年来糖尿病性黄斑水肿的定义、分类、发病机制以及不同药物治疗等有关报道进行了综述.随着对各种药物不断深入地研究,糖尿病性黄斑水肿可得到及时治疗.使糖尿病患者的视力受到保护. 相似文献
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糖尿病黄斑水肿的处理 总被引:4,自引:0,他引:4
糖尿病视网膜病变是工作年龄人群致盲重要原因,而糖尿病黄斑水肿是引起糖尿病患者视力下降的主要原因,早期发现,适当治疗能有效减少因糖尿病性黄斑水肿引起的视力丧失。目前光凝是治疗糖尿病黄斑水肿最有效的方法。对有些病人,玻璃体切割术被证明是有效的。 相似文献
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管怀进 《中华实验眼科杂志》2021,(4):273-279
超声乳化晶状体摘出术虽然微创、有效且安全,但仍会因为手术的操作和仪器的工作而损伤眼内组织的正常结构,影响前房和玻璃体组织结构的稳定性和血-眼屏障,引起炎性因子的释放,导致玻璃体液化或后脱离、视网膜脱离、黄斑水肿,或加重糖尿病视网膜病变、年龄相关性黄斑变性及高度近视性视网膜病变等病情。眼科医师应充分了解超声乳化晶状体摘出... 相似文献
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糖尿病性黄斑水肿(diabetic macular edema,DME)是引起糖尿病患者视力恶化的主要原因。自激光应用于眼科以来,根据资料和研究表明激光治疗黄斑水肿可以稳定和提高患者的视力。本文就DME的病因分型、激光治疗的原理、治疗方法、治疗效果、相关问题和合理应用进行综述。 相似文献
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糖尿病视网膜病变(DR)是糖尿病的严重并发症之一,而糖尿病视网膜病变黄斑水肿(DME)是DR的组成部分,同时也是影响视力的重要原因,目前我国的糖尿病视网膜病变(DR)的分期标准,未将黄斑水肿进行分级。现就我院自2000—2005年在眼科门诊确诊为DR并进行荧光素眼底血管造影的500例病例资料进行回顾性分析,探讨DME与糖尿病分期的关系。 相似文献
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Gemmy CM Cheung MD PhD Young Hee Yoon MD PhD Lee Jen Chen MD Shih Jen Chen MD Tara M George MD Timothy YY Lai MD Kyu Hyung Park MD Sjakon G Tahija MD Harvey S Uy MD Tien Y Wong MD PhD 《Clinical & experimental ophthalmology》2018,46(1):75-86
Diabetic macular oedema is the most common cause of diabetic retinopathy‐induced vision loss. Efficacy of anti‐vascular endothelial growth factor therapy in diabetic macular oedema has been demonstrated in randomized controlled trials. An Asian‐specific guideline for diabetic macular oedema treatment is needed as patients in Asia tend to present with far more advanced disease than seen elsewhere in the world. Previous reviews of diabetic macular oedema management lacked a broader assessment of anti‐vascular endothelial growth factor treatment choices and newer trials. Recent clinical trial data allow head‐to‐head comparisons between the different anti‐vascular endothelial growth factor agents and treatment regimens. This review aims to summarize the clinical evidence related to various treatment regimens for clinicians, with a focus on anti‐vascular endothelial growth factor therapies, and to provide guidance on the treatment of diabetic macular oedema in Asian patients. 相似文献
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目的 观察2型糖尿病患者的眼表情况,探讨可能引起糖尿病患者干眼的影响因素。方法 纳入2型糖尿病患者110例110眼、正常受试者46例46眼。所有受试者均进行OSDI主观评分、Keratogragh 5M检查。所有糖尿病患者记录病程、糖化血红蛋白(HbA1c),并行眼底镜及OCT检查评估眼底病变情况,根据有无糖尿病视网膜病变、有无黄斑水肿、HbA1c水平、糖尿病病程长短分组,分析不同分组条件下非侵入性泪膜破裂时间(NI-BUTav)、睑板腺缺失评分、眼红指数、泪河高度及OSDI评分的改变情况。结果 与正常受试者相比,糖尿病患者NI-BUTav降低,OSDI评分、睑板腺缺失评分升高,差异均有统计学意义(均为P<0.05)。HbA1c≥7%的糖尿病患者OSDI评分高于HbA1c<7%的糖尿病患者,差异有统计学意义(P=0.04)。有黄斑水肿的糖尿病患者的OSDI评分、眼红指数均大于无黄斑水肿的患者,差异均有统计学意义(均为P<0.05)。糖尿病病程≥10年的患者泪河高度较病程<10年者显著降低,差异有统计学意义(P=0.00)。结论 2型糖尿病患者泪膜质量下降,干眼的... 相似文献
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Objective : To describe current management practices of diabetic retinopathy used by Australian ophthalmologists. Setting : Two‐page self‐administered questionnaire mailed to 622 ophthalmologists listed with the Royal Australian College of Ophthalmologists. Methods : The survey included questions about practice details such as size and location; specialty; current practice with regard to management of patients with diabetes; confidence in screening for diabetic retinopathy; and a number of patient scenarios related to screening, follow‐up and treatment of diabetic retinopathy. Results : Of the 577 eligible ophthalmologists, 475 (82%) completed the questionnaire. They had been practicing ophthalmology between 1 and 50 years (median 16 years) and 89 (19%) indicated that they had a subspecialty interest either in vitreo‐retinal surgery or in medical retina. For 145 (30.5%) of the ophthalmologists, at least one of their practices was located in a country area. The estimated percentage of patients with diabetes ranged from 0.1 to 60% (mean = 9.9%). Retinal specialists perform between 0 and 750 macular focal photocoagulation procedures per year (mean = 94) compared with a range of 0–350 for non‐retinal specialists (mean = 10.3) (t = 6.1, P < 0.001). The ophthalmologists were presented with a hypothetical patient with cataract requiring surgery and clinically significant macular oedema that would be difficult to treat (but not impossible) because of the cataract. Seventy‐seven ophthalmologists (16%) said they would delay the macular laser therapy until after the cataract surgery had been performed. In multivariate logistic regression models, non‐retinal specialists were 4.44 times as likely to perform the cataract surgery first (95%CL = 1.57, 12.6) and ophthalmologists who had been in practice more than 15 years were 2.50 times as likely to perform cataract surgery first (95%CL = 1.47, 4.26). There were other examples of practice that differed from the National Health and Medical Research Council (NHMRC) guidelines in patient scenarios. The majority of ophthalmologists (60%) expressed a moderate or strong need to learn more about the management of diabetic retinopathy. Discussion : The variability in the management of diabetic retinopathy by Australian ophthalmologists and the desire of ophthalmologists to learn more about diabetic retinopathy provide evidence to support the need for the NHMRC Guidelines for Diabetic Retinopathy. These data will be used to evaluate changes in practice as a result of the implementation of the guidelines. 相似文献
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糖化血红蛋白与激光后持续性糖尿病黄斑水肿的相关性探讨 总被引:1,自引:0,他引:1
目的 探讨糖化血红蛋白(HbA1c)水平对激光治疗后持续性糖尿病黄斑水肿(DME)的影响。方法 对80例患临床意义的黄斑水肿(CSME)并接受激光治疗的患者行回顾性观察,对可能影响治疗效果的几种因素包括年龄、病程、末梢血血糖、HbA1c、胰岛素使用和白内障手术进行统计学分析。结果 激光治疗后DME主要受HbA1c影响。CSME组HbA1c(5.8%~14.5%;平均9%)明显高于消退组(5.2%-9.3%,平均6.8%)(t=5.9,P〈0.05)。HbA1C水平增高,CSME消退可能性减少,其他因素对持续性CSME无显著影响。结论 2型糖尿病患者激光治疗后持续性CSME较水肿消散的患者具有更高的HbA1C水平。HbA1C是一项较血糖更能代表糖尿病控制的重要指标。 相似文献
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目的 探讨玻璃体内注射康柏西普对弥漫性糖尿病性黄斑水肿(diabetic macular edema,DME)的影响。方法 选取2016年7月至2017年7月牡丹江医学院红旗医院眼科收治的弥漫性DME患者51例51眼,将患者分为3组,每组各17例17眼:单纯玻璃体内注射康柏西普0.5 mg组(A组);玻璃体内注射康柏西普0.5 mg联合改良黄斑格栅样光凝组(B组);单纯改良黄斑格栅样光凝组(C组)。分别于治疗前及治疗后1周、1 个月、3个月和6个月对患者进行光学相干断层扫描检测黄斑中心凹厚度(central macular thickness,CMT)、眼底荧光血管造影(fundus fluorescein angiography,FFA)、最佳矫正视力(best corrected visual acuity,BCVA)、裂隙灯、眼压等检查,比较三种治疗方式的疗效和安全性。结果 三种治疗方式均能改善弥漫性DME患者BCVA、CMT、视网膜新生血管渗漏,但A组、B组疗效均优于C组(均为P<0.05)。A组、B组患者BCVA改善情况差异无统计学意义(P>0.05),但B组患者CMT(197.47±45.26)μm及视网膜新生血管渗漏(9.91±3.18)mm2改善情况优于A 组(205.59±47.33)μm、(13.24±4.87)mm2(P<0.001),且无光凝术及康柏西普相关的并发症发生。结论 改良黄斑格栅样光凝术联合玻璃体内注射康柏西普能迅速减轻弥漫性DME及新生血管形成,从而提高患者视力,其疗效优于单纯改良黄斑格栅样光凝术和单纯康柏西普玻璃体内注射。 相似文献
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目的 探讨577 nm激光光凝联合玻璃体内注射康柏西普治疗糖尿病性黄斑水肿的效果。方法 选取2016年1月至2017年3月在我院治疗的糖尿病性黄斑水肿患者81例81眼,根据患者最终选取的治疗方案分为观察组43例43眼和对照组38例38眼,观察组给予577 nm激光光凝联合玻璃体内注射康柏西普治疗,对照组仅给予577 nm激光光凝,观察两组治疗前后最佳矫正视力(best corrected visual acuity,BCVA)和黄斑中心凹厚度(central fovea of macula thickness,CMT),分析观察组BCVA和CMT变化值与初始因素的相关性。结果 随治疗时间延长,观察组和对照组BCVA、CMT相应改善(均为P<0.05);观察组治疗后1个月、3个月和6个月BCVA分别为0.37±0.09、0.44±0.10和0.52±0.13,均明显高于对照组(均为P<0.05);观察组治疗后1个月、3个月和6个月CMT分别为(351.03±41.43)μm、(270.32±40.03)μm和(220.01±32.91)μm,均明显低于对照组(均为P<0.05);BCVA变化值与糖尿病性黄斑水肿病程、治疗前BCVA呈负相关(r=-0.422、-0.410,均为P<0.05);CMT变化值与糖尿病性黄斑水肿病程、治疗前CMT呈负相关(r=-0.430、-0.415,均为P<0.05)。结论 577 nm激光光凝联合玻璃体内注射康柏西普治疗糖尿病性黄斑水肿效果较好,其效果与患者基线BCVA、糖尿病性黄斑水肿病程有一定相关性。 相似文献