慢性缺血性视网膜病变合并颈内动脉血流动力学显著狭窄的治疗方法比较分析

V. V. Tuzlaev, O. V. Kolenko, A. Vasiliev, D. V. Breev
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摘要

目的。慢性缺血性视网膜病变伴颈内动脉血流动力学显著狭窄(ICA)治疗方法的有效性评价。材料和方法。研究纳入40例慢性缺血性视网膜病变(CIR) 3级患者(男性25例,女性15例),年龄61 ~ 75岁(平均73±6.2岁)。根据治疗的不同,将患者分为两组。第一组20人接受综合治疗。第一阶段为视网膜非灌注区激光凝固。然后,2周后,在第二期颈动脉内膜切除术(CE)的ICA。第二组20人接受了CE ICA。除标准研究方法外,还进行了多普勒超声检查(Logiqe, General Electric, USA)。结果。采用分阶段方法治疗严重CIR,可改善功能参数,使患者治疗后的康复时间缩短2倍。结论。我们提出的CIR分期治疗技术,可以阻止视网膜缺血的进展,避免出现导致视力丧失的并发症。关键词:慢性缺血性视网膜病变,视网膜全视网膜激光凝固,眼缺血综合征,颈内动脉
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Comparative analysis of methods for the treatment of chronic ischemic retinopathy associated with hemodynamically significant stenosis of the internal carotid artery
Purpose. Evaluation of the effectiveness of methods for the treatment of chronic ischemic retinopathy associated with hemodynamically significant stenosis of the internal carotid artery (ICA). Material and methods. 40 patients were included in the research (25 men, 15 women) with grade 3 chronic ischemic retinopathy (CIR) aged 61 to 75 years (average 73 ± 6.2). Depending on the treatment, the patients were divided into 2 groups. The 1st group 20 people who received combined treatment. The 1st stage was laser coagulation of retinal nonperfusion zones. Then, after 2 weeks, during the 2nd stage carotid endarterectomy (CE) of the ICA was performed. The 2nd group 20 people who underwent CE ICA. In addition to standard research methods, Doppler ultrasound was performed (Logiqe, General Electric, USA). Results. The use of a staged approach to the treatment of severe CIR led to an improvement in functional parameters and reduced the period of rehabilitation of patients after the treatment by 2 times. Conclusion. The technology of staged treatment of CIR proposed by us makes it possible to stop the progression of retinal ischemia, to avoid the occurrence of complications that lead to loss of vision. Keywords: chronic ischemic retinopathy, panretinal laser coagulation of the retina, ocular ischemic syndrome, internal carotid artery
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