倍频532nm激光治疗视网膜裂孔89例

目的：观察倍频532nm激光治疗视网膜裂孔的治疗效果。方法：应用倍频532nm激光对89例98眼视网膜裂孔患进行治疗,其中大多数采用全包围式光凝裂孔周围。结果：随访6～30mo,裂孔封闭,视网膜下液吸收97眼,占99％。结论：倍频532nm激光治疗视网膜裂孔方便、组织损伤小、疗效高。     

Intravitreal conbercept injection with panretinal photocoagulation for high-risk proliferative diabetic retinopathy with vitreous hemorrhage

AIM: To assess the clinical efficacy and safety of combining panretinal photocoagulation (PRP) with intravitreal conbercept (IVC) injections for patients with high-risk proliferative diabetic retinopathy (HR-PDR) complicated by mild or moderate vitreous hemorrhage (VH), with or without diabetic macular edema (DME). METHODS: Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study. Upon establishing the patient’s diagnosis, an initial IVC was performed, followed by prompt administration of PRP. In cases who significant bleeding persisted and impeded the laser operation, IVC was sustained before supplementing with PRP. Following the completion of PRP, patients were meticulously monitored for a minimum of six months. Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography (FFA) results. Therapeutic effect and the incidence of adverse events were observed. RESULTS: Out of 42 patients (74 eyes), 29 were male and 13 were female, with a mean age of 59.17±12.74y (33-84y). The diabetic history was between 1wk and 26y, and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y. The affected eye received 2.59±1.87 (1-10) IVC injections and underwent 5.5±1.02 (4-8) sessions of PRP. Of these, 68 eyes received PRP following 1 IVC injection, 5 eyes after 2 IVC injections, and 1 eye after 3 IVC injections. Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment, with resolution of DME in 51 eyes 3-48wk after initial treatment. A newly developed epiretinal membrane was noted in one eye. Visual acuity significantly improved in 25 eyes. No complications such as glaucoma, retinal detachment, or endophthalmitis were reported. CONCLUSION: The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.     

抗VEGF时代激光光凝治疗糖尿病视网膜病变的应用进展

糖尿病视网膜病变(DR)是糖尿病患者最普遍和最严重的眼部并发症,也是成人失明的主要原因之一。近年来,以抗血管内皮生长因子(VEGF)制剂为代表的药物治疗已成为DR的一线疗法,但不能逆转视网膜无灌注区、微动脉瘤和毛细血管异常扩张,不能按时接受治疗者有病情进展风险。激光疗法的广泛应用已有40多年历史,可通过消除毛细血管无灌注区,有效降低致盲率,其中广泛视网膜光凝治疗(PRP)一直是DR的主要治疗方法。激光技术不断改进和发展,在保持疗效的基础上,实现了视网膜损害与副作用最小化的目标。通过联合抗VEGF制剂,可实现优势互补,达到更佳疗效。加深对激光及激光联合抗VEGF制剂治疗DR的临床研究,有助于建立符合我国国情的个性化治疗方案。本文就抗VEGF时代激光在DR治疗中的应用进展进行简要综述。     

玻璃体手术治疗儿童型晚期Coats病疗效观察

目的评估玻璃体手术结合眼内电凝、光凝治疗伴渗出性视网膜脱离的儿童型晚期Coats病的疗效。方法采用玻璃体切割、视网膜切开内引流、电凝、光凝及过氟化碳液体应用,治疗伴渗出性视网膜脱离Coats病18例（18只眼）,随访6—24个月（平均16月）。结果术后视网膜复位率100％。3例视力优于术前,余均保持术前视力,眼压控制于正常范围。结论本方法对多数晚期Coats病有效,可以使视网膜复位,维持现有视力和控制继发性青光眼。     

缺血型视网膜中央静脉阻塞全视网膜光凝的疗效观察

目的探讨全视网膜光凝治疗缺血型视网膜中央静脉阻塞的临床效果。方法回顾性分析2003年1月至2005年4月我院收治的缺血型视网膜中央静脉阻塞共68例68眼,其中行532 nm激光全视网膜光凝治疗40眼(激光组),28眼末行532 nm激光全视网膜光凝(对照组),观察对比两组初、末诊视力,新生血管及新生血管性青光眼等并发症情况。随访时间均在8个月以上,平均随访11±2.3个月。结果两组末次随访视力、虹膜新生血管及新生血管性青光眼等并发症发生率有所不同,但比较差异无统计学意义(P>0.05)。结论缺血性CRVO严重损害患者视力,需要积极治疗,全视网膜光凝对于对于预防虹膜新生血管及新生血管性青光眼的疗效不确切。     

光学相干断层扫描血管成像在全视网膜光凝术治疗糖尿病视网膜病变患者预后评估中的临床价值

目的 观察光学相干断层扫描血管成像(OCTA)在全视网膜光凝术(PRP)治疗糖尿病视网膜病变患者预后评估中的临床价值.方法 纳入2019年9月至2020年4月于我院经PRP治疗的58例糖尿病视网膜病变患者为研究对象.患者均行OCTA检查,根据预后情况将其分为预后良好组和预后不良组.比较两组的一般资料(年龄、性别、身体质...     

玻璃体腔注射雷珠单抗联合光凝治疗BRVO继发黄斑水肿

目的：观察玻璃体腔注射雷珠单抗联合视网膜激光光凝治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的临床疗效。

方法：收集我院2013-08/2016-03收治的经散瞳眼底检查、眼底荧光血管造影(FFA)及光学相干断层扫描(OCT)检查确诊的BRVO继发黄斑水肿患者,随机分为2组,最终回访3mo时共47例47眼。观察组采用玻璃体注射雷珠单抗2wk后联合静脉回流区视网膜激光光凝治疗25例25眼,对照组采用单纯玻璃体注射雷珠单抗治疗22例22眼。比较两组患者治疗后1mo的最佳矫正视力(BCVA)、眼压(IOP)、黄斑中心视网膜厚度(CMT)以及并发症情况。

结果：两组治疗后1mo BCVA、CMT与治疗前比较,差异均有统计学意义(P<0.01),而IOP与治疗前比较无统计学意义(P>0.05); 治疗后1mo两组间BCVA、IOP比较差异均无统计学意义(P>0.05),而组间CMT比较差异有统计学意义(P<0.01)。

结论：玻璃体注射雷珠单抗联合阻塞静脉回流区视网膜光凝治疗BRVO的临床疗效明显优于单纯玻璃体注射雷珠单抗治疗,且激光治疗过程中不刺激黄斑,安全性较高。