【摘要】： 目的：評價氬激光光凝治療不同時期視網(wǎng)膜靜脈阻塞(retinal vein occlusion, RVO)的臨床療效；探討氬激光光凝治療視網(wǎng)膜靜脈阻塞的臨床時機和光斑設(shè)置。 方法：回顧性分析我院自2008年2月-2009年7月應(yīng)用日本KOWA眼底熒光血管造影(fundus fluorescein angiography,FFA)確診RVO的患者111例(111眼),其中CRVO患者40例(40眼),HCRVO患者13例(13眼),BRVO患者58例(58眼)。根據(jù)FFA的觀察,將出現(xiàn)毛細血管無灌注區(qū)但尚未有新生血管生成的58眼作為預(yù)防性光凝組,將出現(xiàn)新生血管的53眼作為治療性光凝組。其中預(yù)防性光凝組58眼中CRVO者21眼,BRVO者30眼,HCRVO者7眼。治療性光凝組53眼中CRVO者19眼,BRVO者28眼,HCRVO者6眼；將兩組患者行視網(wǎng)膜激光光凝術(shù),術(shù)后第1,3,6個月后復(fù)查,行視力、最佳矯正視力、裂隙燈、眼底及FFA檢查。如果FFA發(fā)現(xiàn)新的或光凝不及無灌注區(qū)和新生血管未消退則給予補充光凝。兩組均以6個月后的復(fù)查結(jié)果為評價標準。所有患者資料均經(jīng)SPSS統(tǒng)計軟件進行統(tǒng)計學(xué)處理。 結(jié)果：(1)預(yù)防性光凝組58眼光凝后51眼未出現(xiàn)新生血管,占87.9%,7眼出現(xiàn)新生血管,占12.1%,其中一眼出現(xiàn)新生血管性青光眼；治療性光凝組53眼光凝后末次隨訪48眼新生血管萎縮,占90.6%；5眼治療無效,占9.4%,其中一眼出現(xiàn)新生血管性青光眼；兩組比較療效無明顯差異。(2)兩組CRVO患者光凝治療前后視力均較差,無明顯差別；HCRVO患者視力預(yù)后較CRVO稍好；BRVO患者光凝后視力預(yù)后較好�；颊吖饽笠暳λ脚c靜脈阻塞的類型密切相關(guān)。(3)預(yù)防性光凝組Ⅱ級光斑與Ⅲ級光斑治療無顯著性差異；治療性光凝組中Ⅲ級光斑反應(yīng)1個光斑直徑間隔密度優(yōu)于Ⅱ級光斑反應(yīng)1.5光斑直徑間隔密度；結(jié)論：(1)氬激光光凝在抑制和減少RVO引起的眼內(nèi)新生血管方面有顯著療效；當(dāng)新生血管出現(xiàn)時進行光凝治療是RVO患者激光治療的較佳時機；預(yù)防性光凝可以降低新生血管或者新生血管性青光眼的發(fā)生率,但是并不能完全阻止新生血管或者新生血管性青光眼的出現(xiàn)。(2)光凝可不同程度改善視功能,但視力提高程度與視網(wǎng)膜靜脈阻塞的類型密切相關(guān)。(3)光斑設(shè)置：RVO患者出現(xiàn)新生血管之后應(yīng)給予Ⅲ級光斑；未出現(xiàn)新生血管的RVO患者應(yīng)給予Ⅱ級光斑。
[Abstract]:Objective: to evaluate the clinical efficacy of argon laser photocoagulation in the treatment of retinal vein occlusion (retinal vein occlusion, RVO) at different stages, and to explore the clinical timing and spot setting of argon laser photocoagulation in the treatment of retinal vein occlusion (RVO). Methods: 111 patients (111 eyes) with KOWA fundus fluorescein angiography (fundus fluorescein angiography,FFA) in our hospital from February 2008 to July 2009 were analyzed retrospectively. Among them, 40 cases (13 eyes) with), HCRVO were diagnosed by CRVO. 58 cases (58 eyes) with BRVO. According to FFA, 58 eyes with no capillary perfusion but no neovascularization were used as prophylactic photocoagulation group and 53 eyes with neovascularization as therapeutic photocoagulation group. In the prophylactic photocoagulation group, 21 eyes were CRVO, 30 eyes were BRVO and 7 eyes were HCRVO. In the therapeutic photocoagulation group, 19 eyes were CRVO, 28 eyes BRVO, and 6 eyes HCRVO. Retinal laser photocoagulation was performed in both groups, and the visual acuity, best corrected visual acuity, slit lamp, fundus and FFA were examined 3 months after operation. If new or photocoagulation is found in FFA without perfusion and neovascularization does not recede, supplemental photocoagulation is given. The two groups were evaluated by the results after 6 months. All patient data were statistically processed by SPSS statistical software. Results: (1) in the prophylactic photocoagulation group, there were no neovascularization in 51 eyes (87.9 eyes), the neovascularization in 7 eyes (12.1%), and neovascular glaucoma appeared in one eye. In the therapeutic photocoagulation group, 48 eyes were followed up for the last time after 53 eyes, accounting for 90.6%, 5 eyes were ineffective and 9.4%, neovascularization glaucoma appeared in one eye. There was no significant difference between the two groups. (2) the visual acuity of the two groups before and after photocoagulation treatment of CRVO patients were poor, there was no significant difference; the visual acuity prognosis of HCRVO patients was slightly better than that of CRVO, and that of BRVO patients after photocoagulation was better. The level of visual acuity after photocoagulation was closely related to the type of vein occlusion. (3) there was no significant difference in the treatment of grade 鈪，

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