摘要
目的比较传统格栅样激光光凝(macular laser grid photocoagulation,MLG)与577 nm黄色微脉冲激光治疗黄斑水肿(macular edema,ME)的临床疗效。方法经眼底检查及光学相干断层扫描(optical coherence tomography,OCT)检查确诊的ME患者97例116眼纳入研究。将患者采用随机数字表法分为MLG组和微脉冲组,分别为46例57眼、51例59眼。MLG组行561nm黄绿光连续波长激光光凝治疗,微脉冲组患者行577 nm黄色微脉冲激光治疗。治疗前后所有患者均行眼底、矫正视力、OCT及微视野检查,检测其矫正视力、黄斑中心视网膜厚度(central macular thickness,CMT)及黄斑10°范围内视网膜光敏感度。以治疗后6个月为疗效判定时间点,观察患者治疗前后矫正视力、CMT及光敏感度的变化,对比分析治疗前后两组患者矫正视力、CMT及光敏感度差值之间的差异。结果治疗后6个月,MLG组、微脉冲组矫正视力分别为0.41±0.20、0.44±0.18,均较治疗前提高,差异均有统计学意义(t=2.703、3.398,均为P<0.05)。两组治疗前后矫正视力的差值分别为0.07±0.03、0.09±0.02,两组间差值比较差异无统计学意义(t=0.584,P>0.05)。治疗后MLG组、微脉冲组CMT分别为(328.13±107.66)μm、(316.54±73.21)μm,均较治疗前降低,差异均有统计学意义(t=2.028、4.086,均为P<0.05)。两组治疗前后CMT的差值分别为(24.71±11.09)μm、(53.27±13.67)μm,两组差值比较差异无统计学意义(t=1.891,P>0.05)。治疗后MLG组、微脉冲组光敏感度分别为(4.33±1.72)dB、(6.52±2.56)dB;MLG组光敏感度较治疗前降低,差异有统计学意义(t=3.381,P<0.05);微脉冲组光敏感度较治疗前提高,差异也有统计学意义(t=3.569,P<0.05)。MLG组、微脉冲组治疗前后光敏感度差值分别为(-0.89±0.26)dB、(1.12±0.31)dB,两组差值比较差异有统计学意义(t=4.791,P<0.05)。结论 577nm黄色微脉冲激光治疗ME较MLG更为安全有效,在减轻ME、提高患者视力的同时,保护了视功能。
Objective To compare the clinical curative effects of traditional mac- ular laser grid photocoagulation （MLG）and 577 nm yellow micropulse laser for macular edema （ME）. Methods For examination of fundus and optical coherence tomo- graphy （OCT） examination of 97 patients （ 116 eyes） with ME were enrolled in this stud- y. The patients were randomly divided into MLG group （46 cases, 57 eyes） and micro- pulse group （51 cases,59 eyes） ,respectively. MLG group received 561 nm yellow green continuous wavelength laser photocoagulation, and micropulse group underwent 577 nm yellow micropulse laser treatment. Before and after treatment, all patients underwent the examination of fundus, visual acuity, OCT and microperimetry, the corrected visual acuity,central macular thickness （CMT）and macular retinal 10°mean tetinal sensitive （MS） were detected. In 6 months after treatment for curative time points, the changes of corrected visual acuity, CMT and MS before and after treatment were observed,and the differences between corrected visual acuity, CMT and MS of two groups were compared. Results At 5 months after treatment, the corrected visual acuity in MLG group and micropuise group were 0.41 ± 0.20 .0.44 ± 0. 18, respectively, all which were higher than pre-operation, there was statistical difference （ t = 2.703,3. 398 ,all P 〈 0.05 ）. Differences in corrected visual acuity before and after treatment of two groups were 0.07 ± 0.03,0.09 ± 0.02, respectively, there was no statistical difference between two groups （ t = 0. 584, P 〉 0.05 ）. CMT after treatment in MLG group and micropulse group were （ 328.13 ± 107.65）μm, （ 316.54 ± 73.21 ）μm, re- spectively, there were statistical differences between two groups （ t = 2.028,4.086, all P 〈 0.05 ）. Differences in CMT before and after treatment of two groups were （24.71 ± 11.09） μm, （53.27 ± 13.57） μm, respectively, there was no statistical differ- ence between two groups （ t = 1. 891 ,P 〉0.05）. MS after treatment of MLG group and micropulse group were （4.33 ± 1.72） dB, （6.52 ± 2.56） dB, respectively, MS after treatment in MLG group was lower than before treatment （ t = 3.381,P 〈 0.05 ）, and which in micropulse group was increased （ t = 3. 569 ,P 〈 0.05 ）. Differences in MS of MLG, group and micropulse group before and after treatment were （ - 0.89 ± 0.26） dB, （ 1.12 ± 0.31 ） dB, respectively, there was statistical difference between two groups（ t =4.791 ,P 〈0.05）. Conclusion 577 nm yellow micro pulse laser for ME is more effective than MLG, can improve the visual acuity, reduce ME and protect the visual function.
出处
《眼科新进展》
CAS
北大核心
2014年第2期181-183,共3页
Recent Advances in Ophthalmology
