增殖型糖尿病性视网膜病变行全视网膜光凝后5a随访观察

目的:观察增殖型糖尿病性视网膜病变(proliferativediabetic retinopathy,PDR)行全视网膜光凝术(panretinalphotocoagulation,PRP)后5a的疗效及预后分析。方法:对92例149眼PDR患者行PRP治疗后的1,3,6,12mo进行复查,以后每6mo进行复查,并在3mo后均复查FFA,必要时补充光凝,随访5a。结果:视力提高52眼,保持不变71眼,下降26眼。5a后患者的最终矫正视力情况:≤0.01者19眼,～0.1者64眼,～0.5者58眼,>0.5者8眼。在激光后的随访期间血糖水平基本控制在正常范围内的63眼中,5a后只有6眼发生玻璃体积血、牵拉性视网膜脱离等严重并发症,占9.5%,而在血糖水平控制不满意的29眼中,有9眼(31%)发生上述情况。结论:通过早期发现、及时治疗和定期随访观察而减少糖尿病性盲是完全可能的。对于PDR患者,确诊后应立即进行PRP治疗,并制定定期随访计划,必要时应复查FFA或补充激光,同时,要向患者阐明,严格正规的内科治疗,将血糖控制在正常范围内,可有效地降低或延缓PDR发展的倾向。

Five years follow-up study after panretinal photocoagulation in proliferative diabetic retinopathy cases

AIM:To observe the effect and prognosis in patients with proliferative diabetic retinopathy(PDR) five years after panretinal photocoagulation(PRP).METHODS:Totally 92 cases(149 eyes) with PDR were reviewed one month,three months,six months,one year and then half-yearly after PRP treatment,and reviewed FFA after three months,if necessary,added photocoagulation.All patients were reviewed for the statistics and the conclusion.RESULTS:Visual acuity improved in 52 eyes,unchanged in 71 eyes,decreased in 26 eyes.So...