雷射光凝固治療糖尿性黃斑部病變之臨床比較

Comparison of Argon Laser Photocoagulation on Diabetic Maculopathy by Pan-Retinal, Pan-Retinal Plus Focal, Multifocal, Grid and C-Shape Treatment

林嘉理(Chia-Lee Lin) ； 林振隆(Cheng-Long Lin) ； 劉榮宏(Jorn-Hon Liu)

《中華民國眼科醫學會會刊》 26卷1期 (1987/05) Pp. 392-399

https://doi.org/10.30048/ACTASOS.198705.0069

摘要

274位糖尿性黃斑水腫忠者，共310眼，分成五組，接受不同方式的鐳射光凝固治療；（一）泛視網膜照射組：112人，128眼。（二）泛視網膜合併局部黃斑照射組：32人，44眼。（三）黃斑多發病灶直接照射組：49人，49眼。（四）黃斑格狀照射組：39人，39眼。（五）黃斑顳側C型照射組：42人，50眼。照射後，經三年長期追踪檢查其視力變化，以及黃斑水腫及硬脂沈積消失之情況，除了黃斑微血管網已遭阻塞破壞之病例外，大部份病例之視力皆有進步或維特不變，72.5%，黃斑水腫及脂質沈澱在半年內逐漸消失，視野亦無絕對性盲點。
結果更進一步顯示，泛視網膜或合併黃斑局部照射組，對高危險性增殖性糖尿視網膜黃斑病變者，有顯著效果。黃斑多發病灶直接照射組，可用來治療早期黃斑水腫及缺血。黃斑格狀照射，則使瀰漫性黃斑水腫充分消退。僅黃斑顳側C型照射，可能因黃斑部之鐳射涵蓋區域不夠，致效果不彰。

並列摘要

Argon laser photocoagulation shows clinically significant in the treatment of diabetic maculopathy. It might reduce the risk of visual loss, increase the chance of visual improvement and decrease the persistent macular edema. Five different types of focal macular photocoagulation were suggested by many authorities in the world literatures. 274 patients, 310 eyes that had diabetic retinopathy with mild or moderate macular edema were assigned to five different groups of Argon laser photocoagulation. There were (1) Pan-retinal photocoagulation in 128 eyes. (2) Pan-retinal plus focal macular photo- coagulation in 44 eyes. (3) Macular multifocal photocoagulation in 49 eyes. (4) Macular grid photocoagulation in 39 eyes and (5) Macular C-shape photocoagulation in 50 eyes. Comparison the 3 years long term follow up results of best correction of visual acuity, visual field, fluorescein angiography and clinical Koda-chrome color fundus pictures were achieved in five groups of the patients.
Most of the patients (72.5%) appeared increase visual acuity at least two line in Snellen chart or maintained their vision as before treatment. And, the macular edema and lipid exudates were gradually absorbed during the follow- up period.
Pan-retinal plus focal macular photocoagulation effected for high risk proliferative diabetic maculopathy group. Multifocal treatment was good for early focal macular ischemia. The most of diffuse macular edema decreased with moderate visual improvement after macular grid photocoagulation. But, the effect of macular C-shape photocogulation was doubtful.

並列關鍵字

diabetic maculopathy ； Argon laser photocoagulation ； PRP ； PRP plus focal ； multifocal ； grid and C-shape laser