多波长激光治疗伴有视网膜脱离的Ⅲ期青少年型Coats病初步观察

目的观察多波长激光治疗伴有轻中度视网膜脱离的Ⅲ期青少年型Coats病的疗效。设计回顾性病例系列。研究对象伴有轻中度视网膜脱离的青少年型Coats病(Shields等分期标准3A期)8例8眼,全部患者视网膜血管均异常扩张和存在散在的粟粒状动脉瘤样改变,周围可见无灌注区;其中交通支形成3眼;病变位于赤道部附近7眼。黄斑部均有黄色渗出,外斜视4眼,内斜视1眼。方法采取在视网膜脱离交界处使用包围式绿光光凝,Ⅲ级光斑,能量200~260 mw;视网膜脱离处使用黄光光凝,能量100~150 mw;血管异常处使用黄光光凝,能量220~240 mw。重复治疗间隔2个月,光凝3~8次。主要指标视力及视网膜脱离复位情况。结果视网膜脱离完全复位4/8眼(50%),脱离范围明显缩小3/8眼(38%),无明显变化1/8眼(13%);视网膜微血管瘤和无灌注区消失5/8眼(63%),大部分消退2/8眼(25%),无明显变化1/8眼(13%);黄斑部渗出明显吸收7/8眼(88%),无明显变化1/8眼(13%)。视力提高6/8眼(75%),无变化2/8眼(25%),无视力下降者。结论本文的小样本资料表明,多波长激光光凝治疗伴有轻中度视网膜脱离的青少年型Coats病有效,无明显视网膜前增殖,能最大限度地保存视力。

Multiple wave length laser-a new therapy for juvenile Coats' disease with mild or moderate retinal detachment

Objective To observe the treatment effect of multiple wave length laser on juvenile Coats' disease with mild or moderate retinal detachment.Design Retrospective case series.Participants 8 patients(8 eyes) were diagnosed as Coats' disease with different extent detachment of retina(Shields' stage IIIA).All eyes had expansion retinal vascular,microangioma,and nonperfusion field.3 eyes had communicating branch.Methods Green laser was used in the borderline of detached retina with energy 200~260 mw.Yellow laser,...