糖尿病视网膜病变激光治疗后视网膜的微细结构变化

发布时间：2018-04-22 06:41

本文选题：糖尿病视网膜病 + 频域光学相干断层扫描　；参考：《中国中医眼科杂志》2016年05期

【摘要】：目的研究糖尿病视网膜病变经氪激光治疗后光凝斑视网膜的微观形态学变化。方法对15例非增殖型糖尿病视网膜病变患者行全视网膜氪激光治疗,应用SD-OCT技术观察激光治疗后1小时,1周,1个月时光凝斑在视网膜各层的微观形态学变化。结果光凝治疗后1 d,视网膜内层结构形态学未发生变化,显著的结构变化开始于外丛状层,经过外核层,外界膜,肌样体区,椭圆体区,光感受器外节,交叉区,最后到达色素上皮层。光凝治疗后1周,光凝斑的直径较前明显减小,界限不清楚;视网膜的内层结构的内核层、内丛状层向下突出,而外层结构的外丛状层则完全呈"V"型结构变化,外核层消失。肌样体区、椭圆体区、交叉区同色素上皮层相互融合,与周围未损伤区域形成断裂。光凝治疗后1个月,两个相邻光凝斑之间的外丛状层形成拱门样结构,肌样体区,椭圆体区,交叉区这三层所形成的高密度复合体的厚度变薄,宽度变窄,呈萎缩状态,色素上皮层的连续性完好。结论视网膜各层在激光治疗后所发生的结构变化,进一步验证了激光对糖尿病视网膜病变的治疗作用。
[Abstract]:Objective to study the micromorphological changes of photocoagulation spot retina in diabetic retinopathy treated with krypton laser. Methods Fifteen patients with non-proliferative diabetic retinopathy were treated with whole retinal krypton laser. The microscopic morphologic changes of coagulation spot in all layers of retina were observed by SD-OCT technique at 1 hour and 1 month after laser treatment. Results at 1 day after photocoagulation, the morphology of the inner layer of the retina did not change, and the significant structural changes began in the outer plexiform layer, passing through the outer nuclear layer, the outer membrane, the myoid region, the ellipsoid area, the outer segment of the photoreceptor, the cross region. Finally, it reaches the pigment epithelium. One week after photocoagulation treatment, the diameter of photocoagulation spot was obviously decreased and the boundary was not clear. The inner plexiform layer of the inner layer of the retina protruded downward, while the outer plexiform layer of the outer layer completely showed a "V" structure change and the outer nuclear layer disappeared. The myoid region, ellipsoid region, cross region and pigment epithelium fuse with each other and break with the surrounding undamaged area. One month after photocoagulation treatment, the outer plexiform layer between two adjacent photocoagulation spots formed arched structure, muscle like region, ellipsoid area and cross zone. The thickness and width of the high-density complex formed by these three layers became thinner, narrower and shrunk. The continuity of the pigment epithelium is intact. Conclusion the changes of the structure of retina after laser therapy further verify the therapeutic effect of laser on diabetic retinopathy.
【作者单位】：首都医科大学宣武医院眼科;
【分类号】：R587.2;R779.63

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