摘要
目的探讨单次Nd-YAG激光治疗黄斑区视网膜内界膜下出血的疗效。方法回顾性非病例对照研究,收集2015年1月至2016年3月临床诊断为视网膜内界膜下出血6例6眼患者的临床资料。6例患者均进行了Nd-YAG激光行视网膜内界膜下积血引流术。术后1个月、3个月门诊复查最佳矫正视力(best corrected visual acuity,BCVA)、进行黄斑区光学相干断层扫描(optical coherence tomography,OCT),观察和记录术后BCVA变化、黄斑区视网膜内界膜下积血消退和并发症情况。结果 6例患者年龄23~60岁。其中4例年轻患者发病与咳嗽有关;1例合并高血压,1例合并双眼糖尿病视网膜病变;眼底镜检查显示黄斑区舟样视网膜内界膜下出血,BCVA从数指(count finger,CF)到0.05,平均视力0.03;发病时间5 h至12 d。Nd-YAG激光单次治疗后所有患者视力即刻部分恢复,积血吸收平均时间为2周,术后3个月OCT检查显示黄斑区视网膜内界膜平复,中心凹形态恢复。合并高血压和糖尿病2例患者分别于激光术后2周和1个月因玻璃体大量出血进行了玻璃体切除手术。结论单次Nd-YAG激光治疗单纯性视网膜内界膜下出血是安全有效的。
Objective To observe the efficacy of single Nd-YAG laser treatment for the sub-inner limiting membrane（sub-ILM） haemorrhages in the macular region. Methods This is an uncontrolled case series retrospective study. Nd-YAG laser was performed for 6 patients （6 eyes） with premacular sub-ILM haemorrhages. The best corrected visual acuity（BCVA） and optical coherence tomography （OCT） in macular were observed at 1 day, 1 week, 1 month and 3 months after operation. The conditation of hematopoietic drainage and complications of macular retina were recorded. Results Sub-ILM haemorrhages were clinically confirmed in 6 patients （aged from 23 to 60 years old）, including 4 cases of paroxysm associated with cough, 1 case of hypertension, and 1 case of diabetic retinopathy. Funduscopic examination showed sub-inner limiting membrane hemorrhage in the macular region, BCVA count finger （CF） was 0.05 （ averagely 0.03 ）. The onset time was from 5 hours to 12 days. All the patients were treated with Nd-YAG laser treatment once, and all of them resulted in excellent partial visual recovery immediately. The average hemorrhage absorption time was 2 weeks. OCT examination showed macular retinal inner limiting membrane calm and foveal shape recovery at 3 month after laser treatment. However, the two patients with hypertension and diabetes reeieved vit- rectomy at 2 weeks and 1 month after laser surgery respectively because of serious vitreous hemorrhage. Conclusion Single Nd-YAG laser is a safe and effective method in the treatment of simplicity sub-ILM haemorrhages.
作者
孟晓红
冉黎
李世迎
王一
MENG Xiao-hong RAN Li LI Shi-ying WANG Yi(Department of Ophthalmology, Southwest Hospital, Third Military Medical University, Chongqing 400038, Chin)
出处
《局解手术学杂志》
2017年第3期181-184,共4页
Journal of Regional Anatomy and Operative Surgery
