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Clinical Observation of Laser Photocoagulation for Severe NPDR and Early PDR

Author: WenYi
Tutor: GuoXiaoJian
School: Central South University
Course: Ophthalmology
Keywords: Severe non- proliferative diabetic retinopathy Early proliferative diabetic retinopathy Severe macular edema Modified grid pattern photocoagulation Panretinal photocoagulation Laser treatment options
CLC: R779.63
Type: Master's thesis
Year: 2009
Downloads: 35
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Abstract

Objective To observe the different photocoagulation regimens associated with severe macular edema, severe NPDR and early PDR patients clinical efficacy of laser treatment the best time and the best solution. Method 1 of the 50 patients with severe macular edema, severe NPDR joint group were randomly divided into the affected eye and a single group, a joint group of 26 patients, a single group of 24 patients in the combination group improved a plaid pattern photocoagulation joint panretinal photocoagulation treatment single group modified grid pattern photocoagulation treatment, follow-up six months after treatment, observation BCVA, OCT, FFA, MF-ERG, visual field changes. 2 of 42 patients with macular edema associated with severe early PDR affected eyes were randomly divided into combined group and single group, the combined group of 22 patients, a single group of 20 patients, the combined group using the modified grid pattern photocoagulation joint panretinal photocoagulation treatment, a single group panretinal photocoagulation treatment, follow-up six months after treatment, observation BCVA, OCT, FFA, changes in the field of vision. Results. Associated with severe macular edema in patients with moderate and severe NPDR laser treatment results: (1) the combination group and a single set of photocoagulation treatment BCvA remained stable compared with before treatment was no significant difference; BCVA compared to the degree of change between the two groups There was no significant difference. (2) the combination group and a single set of photocoagulation treatment of macular edema alleviate significant difference compared CFT thinning photocoagulation treatment; CFT degree of change between the two groups showed no significant difference. (3) the combination group most of the patients with no perfusion varying degrees subsided; single group all patients after treatment the perfusion area did not change or increase, changes in the degree of non-perfusion areas before and after the treatment of the combined group, with a single set of photocoagulation compared significant differences. (4) The combined group photocoagulation patients, 10 ° and 30 ° visual field mean threshold sensitivity after treatment were lower compared with photocoagulation treatment before significant difference; single group photocoagulation treatment in patients with a 10 ° field of view, the average threshold sensitivity reduce compared with photocoagulation treatment before there is a significant difference. (5) The combined group with a single group photocoagulation treatment of MF-ERG examination P1 N1 wave amplitude density decreased and treatment before significant difference; extend the combined group P1 latency ring 3,4 and quadrant 4 with significant difference before treatment; the single group P1 latency in the ring 3,4,5 extend, and treatment before significant difference; between the two groups, the P1 and N1 wave amplitude density and incubation period before and after laser treatment showed no significant difference. 2. Early laser treatment of PDR patients with severe macular edema results: (1) the combination group and a single set of photocoagulation treatment BCVA remained stable compared with before treatment was no significant difference; degree of change in BCVA between the two groups compared significant difference. (2) joint group photocoagulation treatment of macular edema alleviate significant difference compared CFT thinning photocoagulation treatment; single group photocoagulation treatment CFT, although thinner, but before photocoagulation treatment no significant differences; between the two groups, the extent of jointly CFT thinning is greater than a single group, the difference was statistically significant. (3) the combination group and a single set of photocoagulation treatment neovascularization after varying degrees subsided was no significant difference between the two groups before and after treatment of neovascular regression of. (4) The combined group photocoagulation patients, 10 ° and 30 ° visual field mean threshold sensitivity after treatment were lower compared with photocoagulation treatment before significant difference; single group photocoagulation treatment in patients with a 30 ° field of view, the average threshold sensitivity reduce compared with photocoagulation treatment before there is a significant difference. Conclusion 1. Severe NPDR patients with severe macular edema, a single modified grid pattern photocoagulation and improved plaid pattern photocoagulation combined panretinal photocoagulation two treatment regimens shortly maintaining visual acuity and reduce the the macular edema role on no significant differences were having a good therapeutic effect. But improved lattice photocoagulation combined with panretinal photocoagulation therapy is superior to a single modified grid pattern photocoagulation treatment subsided on the role of non-perfused area. 2. Early PDR patients with severe macular edema, a single panretinal photocoagulation and improved a plaid pattern photocoagulation joint panretinal photocoagulation for the two treatment regimens shortly maintain vision and subsided no significant difference in the role of neovascularization are having good therapeutic effect. But the modified lattice photocoagulation joint panretinal photocoagulation therapy better than a single role in reducing macular edema, retinal photocoagulation. Photocoagulation caused damage to the function of the retina, mainly for patients with MF-ERG check P1 and N1 wave amplitude density decreased after treatment. But grid pattern photocoagulation combined panretinal photocoagulation treatment with a single lattice photocoagulation treatment, both due to the MF-ERG P1, N1 wave amplitude density decreased degree of no significant difference, namely, the United panretinal photocoagulation did not further aggravate the decline in retinal function. Modified grid pattern photocoagulation can significantly reduce the average threshold sensitivity of patients with central 10 ° field of view, panretinal photocoagulation can significantly reduce the average threshold sensitivity of patients with central 30 ° field of view.

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