糖尿病網膜症之治療

光凝固療法(Photocoagulation)是目前治療糖尿病網膜症的方法之一，它的效果如何，仍在尋求階段，作者研究分三階段，首先對6例採局部光凝固療法，追踪期間5至23個月，其中4例有效；第二階段採用全網膜光凝固療法，有11例，追踪期間1至6個月，其中5例視力獲改善，4例保持原有視力，而2例視力減退；第三階段繼續第二階段研究，病例17例，保持原有視力占9例(56.3%)追踪期間最長1年4個月。光凝固療法可以減少糖尿病網膜症所引起的嚴重視力喪失及阻止增殖性網膜症之進行，但是它也會引起視野狹窄及視力障碍的併發症，本文研究選譯重度糖尿病網膜症病例，嘗試作網膜全面的凝固，追踪觀察光凝固療法的績效，此乃初步結果報告，詳細報告須待將來收集更多病例，經過更長時間追踪研究。

關鍵字

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並列摘要

Diabetic retinopathy is now a leading cause of blindness and visual disability in developed countries. Such cases are increasing steadily in this country too. Because of ineffectiveness of medical treatment and of risk by surgery (Pituitary ablation) for proliferative retinopathy, the application of photocoagulation is becoming more and more popular recently. Although there is still some controversy, the majority of investigator advice photocoagulation to diabetic retinopathy. In the first step of this study focal photocoagulation is applied to 6 cases. Repeated visual acuity determination, visual field, fundoscopic examination, fluorescein angio graphy of fundus, E. R. G. and BOG were done routinely for follow up. Carl Zeiss Xenon arc photocoagulation was used. Among 6 cases of focal photocoagulation group 4 cases (one case of Wagener Stage IV and 3 cases of Stage V) showed effective and 2 cases showed ineffective. In the next step of this study panretinal photocoagulation is applied to 17 cases. We have experiened 120 cases of diabetic retinopathy in Fluorescein angiography during past 3 yrs. 47.5% (57 cases) of all cases had back-ground retinopathy, 52.5% (63 cases) had proliferative retinopathy and 27.5% of proliferative case received photocoagulation treatment. Complete data was obtained in 17 cases of photocoagulation treated group. We performed VA, fundus, ERG, EOG & FAG in those p't received photocoagulation before and after treatment. Except one case expired during follow up, 56.4% (9 cases) showed effect with photo- coagulation and 43.6% (7 cases) didn't show effect with photocoagulation. Photocoagulation reduced the rate of development of severe visual loss and inhibited the progression of retinopathy. It also can improve VA with reducing macular edema & prevention severe vitreous hemorrhage.

並列關鍵字

Photocoagulation ； Xenon Arc ； Diabetic retinopathy ； Argon laser ； Proliferative diabetic retinopathy

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糖尿病網膜症之治療

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