激光光凝治疗糖尿病视网膜病变的疗效观察

Hetaj K. Sheth, Kshama B Popat, Neeti R. Sheth, Vimal J. Vyas
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摘要

背景:糖尿病视网膜病变(DR)是世界上常见的致盲原因之一。糖尿病慢性高血糖导致视网膜血管进行性功能障碍(微血管病变),导致视网膜缺氧,导致“血管内皮生长因子”(VEGF)表达和“新生血管”形成。激光光凝用于将缺氧区域转化为缺氧区域,从而减少VEGF释放的机会,从而减少新生血管的形成。目的:探讨激光视网膜光凝治疗DR后的视力效果。材料和方法:本研究对2012年11月至2014年9月期间在拉杰科特p.d.政府医学院眼科就诊的44例DR患者的80只眼睛进行了激光视网膜光凝。所有患者均接受了视力评估、+90屈光度晶状体前段检查、后段检查和眼底荧光素血管造影。(FFA)。然后进行激光视网膜光凝。分别于激光治疗后第1周、第1个月、第3个月和第6个月对患者进行最佳矫正视力(BCVA)评估,并对结果进行分析。结果:80%的患者BCVA改善,17.5%的患者BCVA维持不变,2.5%的患者BCVA恶化,差异有统计学意义(配对t检验,p<0.0001)。结论:糖尿病视网膜病变导致视网膜血管功能明显紊乱,影响视力。及时使用激光视网膜光凝治疗可以防止进一步的功能障碍,并挽救涉及视网膜,导致视觉和生活质量的统计学显著改善。关键词:糖尿病视网膜病变,视力,激光视网膜光凝
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A study on visual outcome after laser photocoagulation in diabetic retinopathy cases
Background: Diabetic retinopathy (DR) is one of the common causes of blindness in the world. Chronic hyperglycemia in diabetes causes progressive dysfunction of the retinal vasculature (microangiopathy) causing retinal hypoxia leading to expression of „Vascular endothelial growth factor‟ (VEGF) and „neovascularization‟. Laser photocoagulation is used to convert hypoxic areas into anoxic areas thus decreasing chances of release of VEGF and hence neovascularization. Aim: To study the visual outcome after laser retinal photocoagulation in DR cases. Material and Methods: The study was carried out on 80 eyes of 44 patients presenting at Department of Ophthalmology, P. D. U. Govt. Medical College, Rajkot who had DR and underwent laser retinal photocoagulation during period of November 2012 to September 2014. All patients underwent assessment for visual acuity, anterior segment examination, posterior segment examination with +90 Dioptre lens and fundus fluorescein angiography. (FFA). Then laser retinal photocoagulation was done. After laser treatment, patients were assessed for best corrected visual acuity (BCVA) on 1week, 1 month, 3 months and 6 months and the results were analysed. Results: 80% of the patients showed improvement in BCVA, 17.5% of the patient maintained same BCVA and 2.5% patients showed deterioration in BCVA which was statistically significant (paired t-test, p<0.0001). Conclusion: Diabetic retinopathy causes significant dysfunction of retinal vasculature and hence retina, hampering vision. Timely treatment with laser retinal photocoagulation prevents further dysfunction and salvages involved retina causing statistically significant improvement in vision and quality of life. Keywords: Diabetic Retinopathy, Visual Acuity, Laser retinal photocoagulation.
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Journal of Research in Medical and Dental Science
Journal of Research in Medical and Dental Science MEDICINE, RESEARCH & EXPERIMENTAL-
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