阈下值二极管激光治疗糖尿病性黄斑水肿的临床观察

目的:比较阈下值二极管激光(810nm)和传统的氩激光(514nm)光凝术在治疗临床显著糖尿病患者的黄斑水肿的疗效。方法:23例患者32眼,随机选择两种激光光凝之一进行治疗,并随诊至少5个月。检测视力变化及眼部光学相干断层扫描检查黄斑水肿的变化。结果:在整个观察期间,所有治疗者的视力均保持稳定。视网膜中心凹及周围的厚度变化很小。局部黄斑水肿的患者,在二极管激光光凝术后3个月,视网膜中心凹厚度显著下降(250±77)μm,P=0.02]。结论:阈下值二极管激光和常规的氩激光光凝治疗在视力方面有相同的疗效。而阈下值二极管激光光凝治疗黄斑水肿疗效稳定,甚至疗效更佳。以二极管激光光凝为主辅以氩激光光凝治疗可能更有利于减轻糖尿病性黄斑水肿。

Clinical Observation of Subthreshold Diode Laser Treatment in Diabetic Macular Edema

Objective: To compare the effectiveness of subthreshold diode laser(810 nm) and conventional argon laser(514 nm) photocoagulation for the treatment of macular edema in diabetic patients.Methods: A total of 32 eyes of 23 patients were randomized to either treatment.Follow up was conducted for a minimum of five months.Changes in visual acuity and macular edema were observed by optical coherence tomography.Results: Visual acuity remained stable in all treatment groups throughout the observation period.Changes in retinal thickness were small in both fovea centralis and peri-fovea centralis.In patients with focal macular edema,a significant reduction in retinal thickness(250±77] μm,P=0.02) in fovea centralis was seen three months after diode laser photocoagulation.Conclusion: Subthreshold diode laser and conventional argon laser treatment showed an equally good effect on visual acuity.Subthreshold micropulse diode laser showed a stabilizing or even improving effect on macular edema.The combination of primary diode laser and supplementary argon laser might be particularly favourable in reducing diabetic macular edema.