[1]陈家欣,吴瑜瑜. 全视网膜光凝术对糖尿病视网膜病变视网膜神经纤维层及黄斑区视网膜的影响[J].眼科新进展,2015,35(4):380-383.[doi:10.13389/j.cnki.rao.2015.0103]
　CHEN Jia-Xin,WU Yu-Yu. Effects of panretinal photocoagulation on retinal nerve fiber layer and macular retina in patients with diabetic retinopathy[J].Recent Advances in Ophthalmology,2015,35(4):380-383.[doi:10.13389/j.cnki.rao.2015.0103]
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 全视网膜光凝术对糖尿病视网膜病变视网膜神经纤维层及黄斑区视网膜的影响
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
35卷
期数:
2015年4期
页码:
380-383
栏目:
应用研究
出版日期:
2015-04-05

文章信息/Info

Title:
 Effects of panretinal photocoagulation on retinal nerve fiber layer and macular retina in patients with diabetic retinopathy
作者:
 陈家欣; 吴瑜瑜
 362000　福建省泉州市，福建医科大学附属第二医院眼科
Author(s):
 CHEN Jia-Xin ; WU Yu-Yu
 Department of Ophthalmology , the Second Hospital of Fujian Medical University , Quanzhou 362000 , Fujian Province , China
关键词:
 ; 糖尿病视网膜病变; 全视网膜光凝术; 视网膜神经纤维层; 黄斑区视网膜厚度; OCT
Keywords:
 ; diabetic retinopathy;  panretinal photocoagulation;  retinal nerve fiber layer;  macular retinal thickness ;  OCT
DOI:
10.13389/j.cnki.rao.2015.0103
文献标志码:
A
摘要:
 目的　探讨全视网膜光凝术（ｐａｎｒｅｔｉｎａｌｐｈｏｔｏｃｏａｇｕｌａｔｉｏｎ，ＰＲＰ）对糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＤＲ）视网膜神经纤维层（ｒｅｔｉｎａｌｎｅｒｖｅｆｉｂｅｒｌａｙｅｒ，ＲＮＦＬ）及黄斑区视网膜的影响。方法　选取２０１０年６月至２０１３年１２月于我院行ＰＲＰ治疗的１２０例（１２０眼）ＤＲ患者，其中非增生性糖尿病视网膜病变（ｎｏｎ-ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＮＰＤＲ）６０例（ＮＰＤＲ组），增生性糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＰＤＲ）６０例（ＰＤＲ组），同时选取同期于我院健康体检的６０例（６０眼）正常志愿者作为正常对照组。ＰＲＰ手术前后使用ＯＣＴ横向扫描视盘旁ＲＮＦＬ厚度和黄斑区，将视盘旁ＲＮＦＬ和黄斑区分为上方、鼻侧、下方和颞侧４个象限进行扫描，获取各象限及全周平均视盘旁ＲＮＦＬ厚度及黄斑区视网膜厚度，并对结果进行统计分析。结果　与正常对照组相比，ＮＰＤＲ和ＰＤＲ组ＰＲＰ前视盘上方、下方、鼻侧象限、全周平均ＲＮＦＬ厚度均降低（均为Ｐ＜０．０５），但颞侧象限ＲＮＦＬ厚度差异均无统计学意义（均为Ｐ＞０．０５）；ＮＰＤＲ组和ＰＤＲ组ＰＲＰ前不同象限及全周平均ＲＮＦＬ厚度相比，差异均无统计学意义（均为Ｐ＞０．０５）。与ＰＲＰ前相比，ＮＰＤＲ、ＰＤＲ组ＰＲＰ后各象限及全周平均ＲＮＦＬ厚度均变薄，但只有上方、下方及全周平均ＲＮＦＬ厚度差异均有统计学意义（均为Ｐ＜０．０５）；与ＮＰＤＲ组相比，ＰＤＲ组上方、下方、鼻侧及全周平均ＲＮＦＬ厚度变薄更明显，差异均有统计学意义（均为Ｐ＜０．０５）。与正常对照组相比，ＮＰＤＲ和ＰＤＲ组ＰＲＰ前各象限及平均黄斑区视网膜厚度均增加，差异均有统计学意义（均为Ｐ＜０．０５），且ＰＤＲ组较ＮＰＤＲ组增加更为明显，差异均有统计学意义（均为Ｐ＜０.０５）。与ＰＲＰ前相比，ＮＰＤＲ、ＰＤＲ组ＰＲＰ后各象限及平均黄斑区视网膜厚度均增加，差异均有统计学意义（均为Ｐ＜０．０５），且ＰＤＲ较ＮＰＤＲ组增加更为明显，差异均有统计学意义（均为Ｐ＜０．０５）。结论　ＰＲＰ对ＤＲ患者ＲＮＦＬ有一定损伤，应选择适当的激光能量与曝光时间，最大限度地降低对ＲＮＦＬ的影响。
Abstract:
 Objective To discuss the effects of panretinal photocoagulation ( PRP) on retinal nerve fiber layer ( RNFL) and macular retina in patients with diabetic retinopathy ( DR). Methods A total of 120 patients ( 120 eyes) with DR underwent PRP in our hospital from June 2010 to December 2013 were chosen and studied. including 60 cases with non-proliferative diabetic retinopathy ( NPDR group) and 60 cases with proliferative diabetic retinopathy ( PDR group). In addition, 60 healthy persons were chosen as normal control group. The RNFL thickness ( anterior, nasal, temple, inferior, average) and macular retinal thickness ( anterior, nasal, temple, inferior. all quarters) were detected by OCT before and after PRP, the results were compared and analyzed. Results Compared with normal control group , the RNFL thickness at superior. inferior and nasal quarter before PRP of NPDR and PDR groups were all decreased ( all P < 0. 05 ) . but the difference at temple quarter was not different ( all P > 0. 05 ) . and there was no statistical difference in each quarter and average before PRP between NPDR group and PDR group ( all P > 0. 05 ) . Compared with before PRP. the RNFL thickness at each quarter and average thickness after PRP of NPDR and PDR groups were all decreased. but the differences at superior, inferior quarter and average were significant ( all P < 0. 05 ) , and the differences between NPDR group and PDR group were significant ( all P < 0. 05 ) . Compared with normal control group , the macular retinal thickness at each quarter before PRP of NPDR and PDR groups were all increased ( all P < 0. 05 ) . and the differences between NPDR group and PDR group were sigruficant ( all P < 0. 05 ) . Compared with before PRP. the macular retinal thickness at each quarter and average thickness after PER of NPDR and PDR groups were all increased ( all P < 0. 05 ) , and the differences between NPDR group and PDR group were significant ( all P < 0. 05 ) . Conclusion PRP can damage the RNFL , and we should choose the proper laser energy and photocoagulation time to reduce the damages utmostly.

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更新日期/Last Update: 2015-03-31