糖尿病性黄斑水肿激光治疗前后微视野变化研究
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摘要
目的：
评估激光治疗对糖尿病黄斑水肿患者视功能的影响。
方法：
对符合入选标准的23例40只眼糖尿病性视网膜病变患者行专科检查,眼底荧光血管造影了解水肿情况,在光凝前、光凝后3个月分别对患者进行光学相干断层扫描黄斑中心凹视网膜厚度,并采用MP-1微视野仪对相同患者行中心10。平均视网膜光敏度、固视稳定性(固视稳定或固视不稳定)、固视位置(中心固视或偏中心固视)检查。填写DME症状统计表及观察表,包括一般资料、全身症状、舌脉、国际标准视力表最佳矫正视力、激光治疗前、治疗后1个月及3个月各个阶段MP-1微视野情况等；最后将所有资料录入数据库,进行配对t检验、秩和检验及双变量相关进行统计与分析。
结果：
23个患者40只眼,激光治疗后3个月视力、平均视网膜光敏度、固视稳定性、固视位置及黄斑厚度与激光治疗前差异有显著统计学意义；激光治疗前后视力、固视稳定性、固视位置及平均视网膜光敏度与黄斑厚度呈负相关,相关性有统计学意义；激光治疗前后视力与平均光敏感度呈正相关,相关性有统计学意义；激光治疗前后固视位置及平均光敏度与固视稳定性呈正相关,相关性有统计学意义；中医证型与激光前后视力无相关性。
结论：
资料显示,激光对糖尿病性黄斑水肿患者视力、黄斑厚度、视网膜光敏感度、固视稳定性、固视位置在治疗后3个月有明显改善作用。
Purpose
To evaluate the efficacy of the laser treatment for diabetic macular edema patients'visual function.
Methods
The40eyes of23cases with diabetic retinopathy accorded with the criteria, who underwent specialized examination, fundus fluorescein angiography understand retinal edema and leak.
Central macula fovea thickness was measured by optical coherence tomography in pre-photocoagulation and post-photocoagulation3months. Main outcome measures were mean central retinal sensitivity, position of fixation (central or eccentric) and stabi lity of fixation (stable or unstable) within the central10°areas by the MP-1microperimeter.
Fill in DME symptoms statistics and observation table, including general Information, general symptoms, tongue and pulse conditions, best-corrected visual acuity (BCVA)was evaluated by means of an Intemational visual chart. Before laser therapy and after treatment1month and3months each stage MP-1. The last will all material recorded database, the paired t-test, Wilcoxon signed-rank test and bivariate correlation to statistic analysis by using SPSS17.0statistic software.
Results
Forty eyes of23patients. between before and after laser treatment3months, best-corrected visual acuity (BCVA), mean retinal sensitivities, fixation stability, fixation location, central macular thickness (CMT), showed statistically significant differences. before and after laser treatment, BCVA, mean retinal sensitivities, fixation stability, fixation location, were significantly associated with CMT, which were negatively correlated. before and after laser therapy, BCVA, was significantly associated with mean retinal sensitivities, which were positive correlated. before and after laser treatment, mean retinal sensitivities, fixation location, were significantly associated with fixation stability, which were positive correlated. Between traditional chinese medicine (TCM)syndrome differentiation typing and BCVA of before and after laser treatment have no correlation.
Conclusions:
The data show that BCVA, CMT, mean retinal sensitivities, fixation stability, fixation location, which have obviously improved after laser photocoagulation3months.
评估激光治疗对糖尿病黄斑水肿患者视功能的影响。
方法：
对符合入选标准的23例40只眼糖尿病性视网膜病变患者行专科检查,眼底荧光血管造影了解水肿情况,在光凝前、光凝后3个月分别对患者进行光学相干断层扫描黄斑中心凹视网膜厚度,并采用MP-1微视野仪对相同患者行中心10。平均视网膜光敏度、固视稳定性(固视稳定或固视不稳定)、固视位置(中心固视或偏中心固视)检查。填写DME症状统计表及观察表,包括一般资料、全身症状、舌脉、国际标准视力表最佳矫正视力、激光治疗前、治疗后1个月及3个月各个阶段MP-1微视野情况等；最后将所有资料录入数据库,进行配对t检验、秩和检验及双变量相关进行统计与分析。
结果：
23个患者40只眼,激光治疗后3个月视力、平均视网膜光敏度、固视稳定性、固视位置及黄斑厚度与激光治疗前差异有显著统计学意义；激光治疗前后视力、固视稳定性、固视位置及平均视网膜光敏度与黄斑厚度呈负相关,相关性有统计学意义；激光治疗前后视力与平均光敏感度呈正相关,相关性有统计学意义；激光治疗前后固视位置及平均光敏度与固视稳定性呈正相关,相关性有统计学意义；中医证型与激光前后视力无相关性。
结论：
资料显示,激光对糖尿病性黄斑水肿患者视力、黄斑厚度、视网膜光敏感度、固视稳定性、固视位置在治疗后3个月有明显改善作用。
Purpose
To evaluate the efficacy of the laser treatment for diabetic macular edema patients'visual function.
Methods
The40eyes of23cases with diabetic retinopathy accorded with the criteria, who underwent specialized examination, fundus fluorescein angiography understand retinal edema and leak.
Central macula fovea thickness was measured by optical coherence tomography in pre-photocoagulation and post-photocoagulation3months. Main outcome measures were mean central retinal sensitivity, position of fixation (central or eccentric) and stabi lity of fixation (stable or unstable) within the central10°areas by the MP-1microperimeter.
Fill in DME symptoms statistics and observation table, including general Information, general symptoms, tongue and pulse conditions, best-corrected visual acuity (BCVA)was evaluated by means of an Intemational visual chart. Before laser therapy and after treatment1month and3months each stage MP-1. The last will all material recorded database, the paired t-test, Wilcoxon signed-rank test and bivariate correlation to statistic analysis by using SPSS17.0statistic software.
Results
Forty eyes of23patients. between before and after laser treatment3months, best-corrected visual acuity (BCVA), mean retinal sensitivities, fixation stability, fixation location, central macular thickness (CMT), showed statistically significant differences. before and after laser treatment, BCVA, mean retinal sensitivities, fixation stability, fixation location, were significantly associated with CMT, which were negatively correlated. before and after laser therapy, BCVA, was significantly associated with mean retinal sensitivities, which were positive correlated. before and after laser treatment, mean retinal sensitivities, fixation location, were significantly associated with fixation stability, which were positive correlated. Between traditional chinese medicine (TCM)syndrome differentiation typing and BCVA of before and after laser treatment have no correlation.
Conclusions:
The data show that BCVA, CMT, mean retinal sensitivities, fixation stability, fixation location, which have obviously improved after laser photocoagulation3months.
引文
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[3]黄建良,喻干龙.活血化瘀法治疗糖尿病性视网膜病主38例[J].湖南中医杂志,2000,16(1)：19.
[4]于文州,吕天伟.糖视明方治疗糖尿病性视网膜病变的临床观察[J].山东中医药大学学报,2000,24(5)：360.
[5]蒋莉.熊胆逐瘀片治疗非增殖型糖尿病视网膜病变的临床观察[J].辽宁中医杂志,2001,28(4)：213
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[7]刘玲,郭霞.糖目清治疗糖尿病视网膜病变的临床总结[J].山东中医杂志,2000,19(3)：145
[8]Stela V, Edoardo M, Elisabetta P, et al. Diabetic M acular Edema:Correlation between Microperimetry and Optical Coherence Tomography Findings[J]. Investigative Ophthalmology and Visual Science,2006,4 7:3044—3051.
[9]Justin C, Brown MD, Jan A, et al.Entopic perimetry screening for central diabetic scotomas and macular edema[J]. Ophthalmology,2000,107 (8):755-759.
[10]Brown JC, Solomon SD, Bressler SB,et al. Detection of diabetic foveal oedema. Contact lens biomiemscopy compared with optical coherence tomography[J]. Arch Ophthalmol.2004,122:330-335.
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