评价具有不同特征纤维血管膜的增殖型糖尿病视网膜病变患者全视网膜光凝后的效果
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石家庄市科学技术研究与发展指导计划项目(121461303)


The evaluation of prognosis of application of fluorescence fundus angiography for proliferative diabetic retinopathy fibrovascular membrane
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    目的:应用眼底荧光血管造影(fluorescence fundus angiography,FFA)对符合糖尿病视网膜病变(diabetic retinopathy,DR)Ⅳ~Ⅴ期诊断标准的纤维血管膜进行分析,观察不同部位-形态-大小纤维血管膜的光凝治疗效果。方法:符合DR Ⅳ~Ⅴ期患者56例,98只眼,应用FFA评估所有病例视网膜总体情况。行全视网膜激光光凝治疗,治疗后随访6个月,分别于第1-3-6个月行FFA检查及常规检查,根据疗效分为治疗有效和无效两组。分析治疗前FFA结果,观察两组纤维血管膜的部位-范围-形态。结果:56例患者98只眼中,治疗有效组72(73.5%)只眼,无效组26只眼,共有18只眼转行玻璃体切割术,2只眼发展为新生血管性青光眼。根据治疗前FFA结果,对以上两组病例的纤维血管膜进行对比观察,治疗有效组中合并视盘新生血管情况-纤维血管膜范围-弥漫膜及桥状膜情况与无效组相比差异有统计学意义(P < 0.05)。结论:FFA评估DR患者增生膜位置-形态和大小对临床上行全视网膜激光光凝治疗或进一步行玻璃体切割手术有指导意义。

    Abstract:

    Objective:We applied fluorescein fundus angiography (FFA) to analyze diagnostic criteria of fibrovascular proliferative membranes of diabetic retinopathy (DR) Ⅳ~Ⅴ period, and to observe different parts, shape, and the effects of different sizes of fibrovascular membrane photocoagulation. Methods: A total of 98 eyes from 56 patients with DR Ⅳ~Ⅴ period were analyzed in this study. FFA was performed to evaluate the above-mentioned 56 cases in the general situation of the retina and specified the panretinal photocoagulation treatment. During follow-up of 6 months, the patients were examined by FFA and routine inspection in the 1st, 3rd and 6th months, respectively. According to treatment effects, the 56 cases were divided into two groups:the effective treatment group and the ineffective treatment group. The result of pre-treatment FFA was analyzed and different parts, shapes as well as the treatment effect of different sizes of fibrovascular membrane photocoagulation were observed. Results: A total of 98 eyes from 56 patients were selected. The effective treatment group included 72 eyes and the ineffective treatment group included 26 eyes. The efficiency was 73.5%. There were 18 eyes undergoing vitrectomy and 2 eyes became neovascular glaucoma. According to the results of pre-treatment FFA, we compared and observed the fibrovascular membrane of the two groups. There was a significant difference of angiogenesis of merged optic disc between the two groups (P < 0.05). Furthermore, there was a significant difference of fibrovascular membrane range between the two groups (P < 0.05). Also, the difference of diffuse film membrane and bridge-shaped membrane between the two groups was significant (P < 0.05). Conclusion: The analysis of different parts, shapes and sizes of fibrovascular membranes by FFA has the guiding significance to panretinal photocoagulation treatment and vitrectomy.

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李 丽,任 骞,叶存喜,于 华,殷 莉,王雅从.评价具有不同特征纤维血管膜的增殖型糖尿病视网膜病变患者全视网膜光凝后的效果[J].南京医科大学学报(自然科学版),2015,(1):62-64

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  • 收稿日期:2014-06-05
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  • 在线发布日期: 2015-02-06
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