激光治疗视网膜分支静脉阻塞疗效分析

目的 探讨激光治疗视网膜分支静脉阻塞(hrunch reinal,occlusion，BRVO)的疗效。方法 应用氩激光对158例BRVO患者进行光凝。结果 激光治疗后视力提高2行以上者91例，占57．6％，治愈102例，占64．5％。结论 激光治疗能促进BRVO视网膜出血、渗出及黄斑水肿的吸收。可减少并发症，提高视力预后。     

氩激光治疗黄斑裂孔性视网膜浅脱离疗效及护理对策

[目的]评价氩激光治疗黄斑裂孔性视网膜浅脱离的疗效及护理.[方法]对33例33眼黄斑裂孔性视网膜浅脱离施行氩激光治疗,在激光治疗前后做好相关知识的宣传教育及心理护理.[结果]25眼一次光凝成功（75.8%）,6眼二次光凝成功（18.2%）,2眼二次光凝后未能复位,行玻璃体切割联合气液交换注入全氟丙烷混合气体后复位.光凝后视力提高5眼（15.2%）,视力不变24眼（72.7%）,视力下降4眼（12.1%）.[结论]氩激光治疗黄斑裂孔性视网膜浅脱离成功率高且能有效保持患眼视力     

氩激光对视网膜静脉阻塞患者视功能康复的效果

目的 探讨氩激光对视网膜静脉阻塞的治疗效果。方法 对422例（428眼）视网膜静脉阻塞患者行氩激光治疗,其中缺血型386眼（90．2％）,非缺血型42眼（9．8％）,黄斑囊样水肿129眼（30．14％）。 结果 207眼（48．4％）视力提高,138眼（32．2％）视力无变化,黄斑囊样水肿消失率为84．45％（82／97）。结论 视网膜静脉阻塞采用氩激光治疗可控制新生血管的生成,减轻黄斑囊样水肿,保护视功能。     

玻璃体腔内注射曲安奈德联合激光治疗视网膜分支静脉阻塞所致的黄斑水肿

目的探讨玻璃体腔内注射曲安奈德(triamcinolone acetonide,TA)联合激光治疗视网膜分支静脉阻塞(BRVO)黄斑水肿的疗效。方法经眼底检查、眼底彩色照相、荧光素眼底血管造影(FFA)、部分经光学相干断层扫描(OCT)检查,确诊为BRVO合并黄斑水肿者121例,行玻璃体腔内注射TA联合激光治疗。治疗后平均随访10个月。结果治疗后全部病例黄斑水肿均减轻或消退,其中完全消退者73例(60.33%)。全部病例视力均保持稳定或有所提高,其中视力提高≥2行者48眼(39.67%)。结论适时玻璃体腔内注射TA和激光光凝治疗,可以降低病变区视网膜耗氧量,使受阻区域缺血、缺氧得到改善,血管渗漏减轻,减轻黄斑水肿,有利于视力的恢复。     

氩激光治疗增殖型糖尿病性视网膜病变的临床护理

60例86眼增殖型糖尿病性视网膜病变(DRP)伴黄斑水肿的患者,采用532nm激光进行全视网膜光凝术及黄斑区格栅样光凝。激光治疗后随访6～24个月,86只眼中72只眼治疗有效;76只眼的视力稳定,62只眼黄斑水肿明显减轻;23只眼视网膜新生血管或视盘新生血管完全消退,63只眼部分消退。氩激光全视网膜光凝及激光治疗前后给予认真、细致的护理是保证激光控制和改善增殖型糖尿病性视网膜病变的前提。     

多波长激光治疗视网膜分支静脉阻塞的疗效观察

目的观察多波长氪离子激光光凝治疗视网膜分支静脉阻塞的临床疗效。方法对98例98眼视网膜分支静脉阻塞患者采用多波长氪离子激光光凝治疗,术后定期观察视力、黄斑水肿、视网膜新生血管及无灌注区情况,随访时间6～12个月,平均10个月。结果视力增加76．5％（75／98）,不变者23．5％（23／98）。无一例视力减退。激光治疗前视力0．5以上者占48．98％（48／98）,治疗后为65．31％（64／98）;黄斑水肿完全消退者42．85％（42／98）,部分消退者43．88％（43／98）,不变者13．27％（13／98）。视网膜新生血管完全消退者66．66％（10／15）,部分消退者33．44％（5／15）。视网膜无灌注区经多次激光治疗后,大部分消失。结论多波长氪离子激光光凝治疗视网膜分支静脉阻塞具有较好的治疗效果,且并发症少。     

视网膜分支静脉阻塞黄斑病变的氩绿激光治疗

视网膜分支静脉阻塞（BRVO）激光光凝治疗，疗效肯定。我们在近两年中对视网膜分支静脉阻塞病变波及黄斑区，引起黄斑水肿、黄斑出血、黄斑棉絮斑、黄斑硬性渗出、荧光素眼底血管造影（FFA）黄斑水肿、黄斑无灌注区的病例进行氩绿激光光凝治疗。第一次先进行黄斑区以外病变的光凝治疗，间隔1-3个月FFA后再行黄斑区激光治疗。效果良好，现总结报告如下。     

氩激光治疗糖尿病性视网膜病变30例分析

目的：观察氩激光视网膜光凝治疗各期糖尿病性视网膜病变的治疗效果。方法：选择经眼底荧光血管造影（FFA）检查确诊为糖尿病性视网膜病变患者30例（58眼）,根据FFA及眼底病变情况对微血管瘤及渗漏的毛细血管行局部光凝。对不伴有黄斑水肿按全视网膜光凝术光凝标准范围进行光凝;对弥漫性黄斑水肿行格栅样光凝,之后再行全视网膜光凝。结果：视力增进23只眼,视力无变化26只眼,视力下降9只眼。结论：氩激光视网膜光凝术是治疗DR的有效手段。严格掌握激光治疗的适应证及可能出现的并发症,对DR患者已出现激光治疗指征的情况越早治疗效果越好。     

激光治疗视网膜分支静脉阻塞44例分析

目的探讨多波长氪离子激光治疗视网膜分支静脉阻塞(BRVO)的临床疗效。方法总结分析大庆市人民医院眼科应用氪离子激光仪治疗的44例(44眼)BRVO患者的临床资料。结果治疗后经6~24个月随访,本组显效35眼、有效8眼,总有效率为97.7%;无一例并发黄斑裂孔、视网膜脱离、玻璃体大量积血或继发性青光眼。治疗后视力提高26眼,不变15眼,下降3眼。结论多波长氪离子激光能促进视网膜分支静脉阻塞患者眼底水肿、出血、渗出的吸收,阻止并发症的发生,保护患者视力,疗效显著。     

激光治疗增生性糖尿病视网膜病变弥漫性黄斑水肿的护理

目的 探讨黄斑格栅样光凝联合全视网膜光凝(PRP)治疗增生性糖尿病视网膜病变(PDR)弥漫性黄斑水肿的护理.方法 40例50眼伴有弥漫性黄斑水肿的PDR患者,采用倍频Nd:YAG激光进行黄斑格栅样光凝联合PRP,分析治疗效果及护理特点.结果 激光治疗后随访6～30个月,50眼中36眼治疗有效,占72%; 76%患眼的视力稳定,62%患眼黄斑水肿明显减少;视网膜新生血管或视盘新生血管完全消退者为120%,部分消退者为56%.激光治疗前后经过对患者的心理护理和治疗护理,增进了患者对疾病的认识和随访意识.无一例患者发生激光误伤黄斑中心凹和激光致视网膜出血等并发症,无一例患者发生眼部感染.结论 黄斑格栅样光凝联合PRP是治疗PDR伴有弥漫性黄斑水肿的有效措施.激光治疗前后认真细致的专科护理对保证激光控制或改善PDR具有重要意义.     

Management of macular edema secondary to central retinal vein occlusion: an evidence-based

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity. Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. The most common cause of decreased vision in patients afflicted with BRVO is the accumulation of fluid within the macula (macular edema). The Branch Vein Occlusion Study (BVOS) demonstrated the efficacy of grid laser photocoagulation in the treatment of BRVO-related macular edema. After publication of that report, grid laser became the standard of care for decreased vision due to BRVO-associated macular edema in patients similar to those enrolled in the BVOS. However, several recent major randomized, controlled clinical trials have investigated new therapeutic modalities for the treatment of decreased vision due to macular edema secondary to BRVO. This article aims to provide insight into current evidence-based approaches to management of macular edema secondary to BRVO. A companion article reviews approaches for management of macular edema secondary to CRVO.     

Management of macular edema secondary to branch retinal vein occlusion: an evidence-based update

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity. Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. The most common cause of decreased vision in patients afflicted with BRVO is the accumulation of fluid within the macula (macular edema). The Branch Vein Occlusion Study (BVOS) demonstrated the efficacy of grid laser photocoagulation in the treatment of BRVO-related macular edema. After publication of that report, grid laser became the standard of care for decreased vision due to BRVO-associated macular edema in patients similar to those enrolled in the BVOS. However, several recent major randomized, controlled clinical trials have investigated new therapeutic modalities for the treatment of decreased vision due to macular edema secondary to BRVO. This article aims to provide insight into current evidence-based approaches to management of macular edema secondary to BRVO. A companion article reviews approaches for management of macular edema secondary to CRVO.     

Retinal vein thrombosis: pathogenesis and management

Summary. Retinal vein occlusion (RVO) is the most common retinal vascular disease after diabetic retinopathy. Owing to its multifactorial nature, however, management of this condition remains a challenge. Of the two main types of RVO, branch retinal vein occlusion (BRVO) is more prevalent than central retinal vein occlusion (CRVO). Most patients develop the disease at an elderly age, and more than half of them have associated systemic disorders (e.g. hypertension, hyperlipidemia and/or diabetes mellitus). There is no evidence to suggest routine testing for heritable thrombophilias in patients with RVO. The main cause of the visual impairment is macular edema, while neovascularization of the retina and optic disc are the most serious complications leading to vitreous hemorrhage, retinal detachment and neovascular glaucoma. Macular grid laser photocoagulation is an effective treatment for macular edema in patients with BRVO and a visual acuity of 20/40 or less. Other treatment options for reducing the edema are intravitreal steroids, anti‐VEGF drugs and vitrectomy. The recently introduced intravitreal application of steroids and anti‐VEGF drugs may prove to be a better approach for improving visual acuity. Finally, scatter panretinal laserphotocoagulation can effectively treat neovascularization and its secondary complications.     

康桕西普玻璃体腔内注射联合视网膜激光光凝对缺血型视网膜分支静脉阻塞继发黄斑水肿患者远期视力及预后影响

【目的】探讨康柏西普玻璃体腔内注射联合视网膜激光光凝对缺血型视网膜分支静脉阻塞(BRVO)继发黄斑水肿患者远期视力及预后的影响。【方法】回顾性分析2016年10月至2017年6月在本院诊治的缺血型BRVO继发黄斑水肿患者45例(45眼),所有患者均采用康柏西普玻璃体腔注射联合视网膜激光光凝治疗,比较治疗前和治疗后1周、1个月、3个月、6个月、9个月及12个月患者黄斑中心视网膜厚度(CMT)、最佳矫正视力(BCVA)改变状况,并记录患者并发症与不良反应发生情况。【结果】患者治疗后1周、1个月、3个月、6个月、9个月及12个月时BCVA分别为0.44±0.07、0.45±0.05、0.52±0.07、0.54±0.06、0.62±0.05、0.90±0.10,均显著高于患者治疗前的0.39±0.07;治疗后1周、1个月、3个月、6个月、9个月及12个月时CMT分别是(295.14±63.51)mm、(275.39±60.14)mm、(249.63±61.50)mm、(238.75±62.55)mm、(232.64±64.71)mm、(210.08±60.09)mm,均显著低于治疗前的(679.24±62.31)mm,其差异均有统计学意义(P<0.05),治疗后不同时间点CMT比较差异均无统计学意义(P>0.05)。术后随访中患者未出现医源性白内障、高眼压、视网膜撕裂、玻璃体出血及眼内炎等眼部并发症。【结论】康柏西普联合视网膜激光光凝可显著提升缺血型BRVO继发黄斑水肿患者BCVA,降低CMT,且安全性高,值得临床推广应用。     

玻璃体内注射康柏西普治疗视网膜分支静脉阻塞继发黄斑水肿的临床研究

【目的】初步评价玻璃体腔内注射康柏西普治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿(ME)的疗效及安全性。【方法】对2014年8月至2015年2月就诊于本院眼科已确诊为 BRVO 继发 ME 的患者21例(21眼)的临床资料进行回顾性分析,对患眼均给予玻璃体腔内注射康柏西普,观察术前和术后1 d、1周、1个月、3个月时患者的最佳矫正视力,光学相干断层扫描测定黄斑中心区视网膜厚度的变化。【结果】在21眼中有19眼视力提高,2眼视力不变。治疗前的 LogMRA 视力为0.55±0.74,治疗后1周、1个月、3个月时分别为：0.57±0.70、0.61±0.63、0.62±0.58,其与治疗前相比差异均具有显著性(P <0.05)。黄斑中心凹平均厚度治疗前为(404.25±62.76)μm,治疗后1周、1个月、3个月时分别为(354.25±64.12)μm、(221.75±37.30)μm、(195.30±24.70)μm,治疗后明显改善,与治疗前相比差异具有显著性(P <0.05)。未发现与药物相关的眼部并发症及全身的不良反应。【结论】玻璃体内注射康柏西普治疗 BRVO 继发 ME 患者中短期内可提高视力、减轻 ME,但长期疗效仍需进一步观察。     

116例视网膜静脉阻塞患者临床和荧光素眼底血管造影的观察和分析

目的 :分析视网膜静脉阻塞 (retinalveinocclusion ,RVO)病例的有关资料 ,以提高对该病的检查和诊断水平。方法 :对经荧光素眼底血管造影 (fundusfluoresceinangiography ,FFA)确诊的 116例患者的 12 4只眼的临床和FFA资料进行分析。结果 :CR VO(centralretinalveinocclusion)者 2 7只眼 ;半侧RVO有 8只眼。BRVO(branchretinalveinocclusion) 89只眼 ,共有 93支血管受累 ,其中颞上支占 6 4 % ,为最易受累之血管分支 ;多支血管受累的患者占单纯BRVO的 13.4 1%。另外 ,双眼RVO共 8例 ,占患者总数的 7%。有 5 6只眼存在视网膜毛细血管无灌注区 ,占总眼数的 4 5 .16 % ;有新生血管形成 18只眼 ,占总眼数的 14 .5 2 %。CRVO患者的平均年龄为 6 1.0 8岁 ,BRVO患者的平均年龄为 6 7.0 6岁 ,两者有显著差异 (t=2 .4 5 ,P <0 .0 5 )。结论 :RVO的类型和年龄有一定关系 ;诊断时要考虑双眼RVO及多支BRVO的可能性 ;联合包括直接检眼镜、前置镜和FFA等检查方法能帮助RVO的诊断和指导治疗     

激光治疗糖尿病性视网膜病变的疗效分析

【目的】评价倍频532nm激光治疗糖尿病性视网膜病变（DR）的疗效。【方法】按技术规定的光凝范围和光凝参数采用532nm激光对本院224例415只眼的DR患者行全视网膜光凝、局部视网膜光凝、黄斑格栅样光凝治疗,术前术后均进行视力、裂隙灯、眼底、眼底荧光血管造影（FFA）检查,治疗后1～3个月复查视力及眼底,3个月后复查FFA结果。【结果】一次和追加光凝后,326只眼视力提高或无变化,占78．6％;89只眼视力下降,占21．4％。仍有12眼（2．9％）行玻璃体切割术,4眼（0．9％）因新生血管性青光眼行睫状体冷凝术。【结论】激光治疗DR疗效显著。     

Diabetic retinopathy: a leading cause of new blindness

Some of the basic underlying processes in the development of diabetic retinopathy include changes in the walls of retinal vessels, with occlusion and leakage. These result in edema, hemorrhage, hard exudates, plaques, and ischemia, leading to neovascularization. When proliferative retinopathy supervenes, it may result in complete blindness. Internists and family practice physicians should be alert for early signs of diabetic retinopathy. Ideally, diabetic patients should have their eyes examined yearly by an ophthalmologist. A fundus examination without dilation and usually without acuity testing rarely detects proliferative or early background retinopathy. Multicenter studies have shown that photocoagulation of new vessels with the argon laser may significantly reduce the incidence of severe visual loss. This treatment method has the potential of reducing the incidence of diabetic blindness by 60% to 80%. Photocoagulation is not a "cure" for diabetic macular edema; when used judiciously, however, it can sometimes further reduce visual loss caused by this common disease. The course of diabetic retinopathy in individual cases is unpredictable. After photocoagulation, some patients cannot see as well as before, though in others the progress of the disease is arrested. There is a conservative concern about a procedure that destroys retinal tissue in the hope of limiting the progression of the disorder. Yet photocoagulation appears to be the only alternative until a better treatment is developed through basic research.     

倍频激光对视网膜静脉阻塞患者视功能康复的作用

目的:评价倍频激光对视网膜静脉阻塞患者视功能康复的作用。方法:对58例(58只眼)视网膜静脉阻塞患者行倍频Nd:YAG激光治疗,随访时间3～20个月,平均9.2个月。结果:激光治疗后52例有效。光凝后视力进步36只眼;视力不变20只眼;视力下降2只眼。结论:倍频激光治疗视网膜静脉阻塞,可有效地保护患者视功能。