糖尿病视网膜病变全视网膜光凝术后玻璃体视网膜界面的变化

发布时间：2018-04-16 16:35

本文选题：糖尿病视网膜病变 + 玻璃体视网膜界面　；参考：《眼科新进展》2014年11期

【摘要】：目的观察比较不同时期糖尿病视网膜病变(diabetic retinopathy,DR)患者全视网膜光凝术(panretinal photocoagulation,PRP)前后玻璃体视网膜界面状态的变化。方法将确诊为2型糖尿病的患者132例217眼随机分为四组:单纯糖尿病组、轻中度非增生期糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)组、重度NPDR组和增生期糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)组,另选取正常对照组26例52眼。采用裂隙灯显微镜加前置镜、B超、光学相干断层扫描(optical coherence tomography,OCT)观察各组患者玻璃体视网膜界面的状态,比较各组玻璃体后脱离(posterior vitreous l detachment,PVD)的发生率,观察NPDR组、PDR组患者行PRP前后PVD的变化。结果重度NPDR组(48.3%)和PDR组(51.7%)PVD发生率高于正常对照组(7.6%),差异均有统计学意义(P0.01)。重度NPDR组(38.3%)和PDR组(32.8%)PRP术后完全性PVD发生率(38.3%、32.8%)高于治疗前(16.7%、12.1%),差异均有统计学意义(均为P0.01)。结论DR常合并异常玻璃体视网膜界面,PRP可以促进增生期DR患者形成完全性PVD,有利于延缓或者阻止DR病变进展,防止视网膜脱离,有利于提高手术疗效。
[Abstract]:Objective to observe and compare the changes of vitreoretinal interface in patients with diabetic retinopathy (Dr) before and after panretinal photocoagulation (PRP) at different stages.Methods 132 patients with type 2 diabetes were randomly divided into four groups: simple diabetic group, non-proliferative diabetic retinopathy group, severe NPDR group and proliferative diabetic retinopathy group.In addition, 26 cases (52 eyes) of normal control group were selected.The vitreoretinal interface was observed by slit lamp microscope and anterior mirror, B-ultrasound and optical coherence tomography (Oct), and the incidence of posterior vitreous l detachable coherence in each group was compared.The changes of PVD in NPDR group were observed before and after PRP.Results the incidence of PVD in severe NPDR group (48.3%) and PDR group (51.7%) was higher than that in normal control group (7.6%). The difference was statistically significant (P 0.01).The incidence of complete PVD in severe NPDR group (38.3%) and PDR group (38.3%) was significantly higher than that before treatment (P 0.01).Conclusion Dr with abnormal vitreoretinal interface PRP can promote the formation of complete PVD in patients with proliferative Dr, delay or prevent the progression of Dr lesions, prevent retinal detachment, and improve the operative effect.
【作者单位】：南方医科大学珠江医院眼科;中南大学湘雅二院眼科;
【基金】：国家自然科学基金面上项目(编号:81371067)~~
【分类号】：R779.6

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