糖尿病性玻璃體出血之視網膜前部冷凍治療

Diabetic Anterior Retinal Cryotherapy in Vitreous Hemorrhage

吳愛卿(Ai-Ching Wu) ； 李安響(Ann-Hseang Lee)

《中華民國眼科醫學會會刊》 28卷2期 (1989/05) Pp. 701-706

https://doi.org/10.30048/ACTASOS.198905.0129

摘要

回顧一年期間，對糖尿病性玻璃體出血58位病人的69隻眼睛，我們做了經結膜之視網膜前部冷凍治療。除冷凍治療前即有牽引性視網膜剝離或血管新生性青光眼及追蹤時間少於三個月片，共有54隻眼睛列入統計分析中；玻璃體出血平均時間為七個月零三週，這蹤平均長達8.3個月。在治療後六個月的41隻眼睛中，視力改善者16眼(39%)，視力穩定者13眼(31.7%)，而減退者僅12眼(29.3%)，於三、六、九、十二個月之視力演變，瀰漫性出血優於非瀰漫性出血。在治療後，六眼(11%)出現復發性玻璃體出血，三眼(6%)有牽引性視網膜剝離，兩眼(4%)有角膜上皮受損，而兩眼(4%)施行了白內障手術。
由於視網膜前部冷凍治療危險性甚低且步驟簡單，對於長期或復發性糖尿病玻璃體出血，除玻璃體切除術外，它也是一種良好的治療方法。

並列摘要

We reviewed transconjunctival anterior retinal cryotherapy (ARC) among 69 eyes, 58 patients with diabetic vitreous hemorrhage in one-year period. The analysed group consisted of 54 eyes excluding pre-ARC tractional retinal detatchment or neovascular glaucoma, follow-up time less than 3 months. The mean duration of vitreous hemorrhage was 7 months and 3 weeks. The length of follow-up averaged 8.3 months. Of the 41 eyes, at 6 months after treatment, visual acuity improved in 16 eyes (39%), remained unchanged in 13 eyes (31.7%), and decreased in 12 eyes (29.3%). The visual outcome of diffuse hemorrhage at 3, 6, 9, 12 months was better than that of non-diffuse hemorrhage. After treatment, recurrent vitreous hemorrhage developed in 6 eyes (11%), tractional retinal detachment in 3 eyes (6%), corneal epithelial defect in 2 eyes (4%), and 2 eyes (4%) underwent cataract operation.
Of relative low risk and being a simple procedure, it is suggested that anterior retinal cry-therapy may be an alternative to ”early” vitrectomy for persistant or recurrent diebetic vitreous hemorrhage.

並列關鍵字

Anterior retinal cryotherapy ARC ； Diabetic vitreous hemorrhage ； Panretinal photocoagulation PRP ； Early vitrectomy