视网膜光凝对糖尿病视网膜病变患者神经纤维层厚度的影响
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摘要
目的:探讨分析糖尿病视网膜病变(diabetic retinopathy,DR)患者全视网膜激光光凝术(panretinal photocoagulation,PRP)治疗后1a视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度的变化。方法:选取2014-05/2017-06在我院行PRP治疗的92例92眼DR患者,采用OCT的DISC CIRCLE程序,测量分析以视盘为中心、直径3. 45mm范围DR患者PRP术前和术后1a (采用Follow-Up程序自动追踪模式)视盘周围RNFL厚度,按视盘上方(S)、下方(I)、鼻侧(N)、颞侧(T)4个象限分区所得的数值进行统计分析。结果:DR患者PRP术后1a较术前视盘周围上方、下方、鼻侧、颞侧和全周平均RNFL厚度明显变薄,且差异有统计学意义(均P<0. 05)。结论:PRP治疗可导致视网膜RNFL变薄,临床上应充分重视和考虑RNFL的损伤,更好地保护视网膜神经细胞的机能对DR治疗具有重要意义。
AIM: To investigate the changes of retinal nerve fiber layer( RNFL) thickness in patients with diabetic retinopathy( DR) after1 a of panretinal photocoagulation( PRP) treatment.METHODS: A total of 92 patients( 92 eyes) with DR who underwent PRP in our hospital from May 2014 to June 2017 were enrolled. The DISC CIRCLE procedure of OCT was used to measure the preoperative and one-year postoperative RNFL of patients with DR in the range of 3. 45 mm diameter around the optic disc,using Follow-Up program automatic tracking mode. The statistical analysis was conducted according to the values obtained in the four quadrant( superior,nasal,temple and inferior).RESULTS: The average RNFL thickness around optic disc of the patients with DR after 1 a of PRP was significantly thinner than the preoperative,the difference was statistically significant( P<0.05).CONCLUSION: PRP treatment can lead to thinning of RNFL in the retina,which should given full attention and consideration the damage of RNFL in clinical practice. The function of protecting retinal nerve cells is of great significance for DR treatment.
AIM: To investigate the changes of retinal nerve fiber layer( RNFL) thickness in patients with diabetic retinopathy( DR) after1 a of panretinal photocoagulation( PRP) treatment.METHODS: A total of 92 patients( 92 eyes) with DR who underwent PRP in our hospital from May 2014 to June 2017 were enrolled. The DISC CIRCLE procedure of OCT was used to measure the preoperative and one-year postoperative RNFL of patients with DR in the range of 3. 45 mm diameter around the optic disc,using Follow-Up program automatic tracking mode. The statistical analysis was conducted according to the values obtained in the four quadrant( superior,nasal,temple and inferior).RESULTS: The average RNFL thickness around optic disc of the patients with DR after 1 a of PRP was significantly thinner than the preoperative,the difference was statistically significant( P<0.05).CONCLUSION: PRP treatment can lead to thinning of RNFL in the retina,which should given full attention and consideration the damage of RNFL in clinical practice. The function of protecting retinal nerve cells is of great significance for DR treatment.
引文
1 Yang W,Lu J,Weng J,et al.Prevalence of diabetes among men and women in China.N Engl J Med 2010;362(12):1090-1101
2 Ciudin A,Hernández C,SimóRI.Iron overload in diabetic retinopathy:A cause or a consequence of impaired mechanisms?Exp Diabetes Res 2010;2010:714108
3陈家欣,吴瑜瑜.全视网膜光凝术对糖尿病视网膜病变视网膜神经纤维层及黄斑视网膜的影响.眼科新进展2015;35(4):380-383
4 Lim MC,Tanimoto SA,Fuflani BA,et al.Effect of diabetic retinopathy and paurefinal photocoagulation on retinal nerve fiber layer and optic nerve appearance.Arch Ophthalmol 2009;127(7):857-862
5 Kim HY,Cho HK.Peripapillary retinal nerve fiber layer thickness change after panretinal photocoagulation in patients with diabetic retinopathy.Korean J Ophthalmol 2009;23(1):23-26
6 The Diabetic Retinopathy Study Research Group.Photocoagulation treatment of proliferative diabetic retinopathy.Clinical application of Diabetic Retinopathy Study(DRS)findings,DRS Report Number 8.Ophthalmology 1981;88(7):583-600
7 Yazdani S,Samadi P,Pakravan M,et al.Peripapillary RNFL thickness changes after panretinal photocoagulation.Optom Vis Sci 2016;93(9):1158-1162
8 Jeon SJ,Park HL,Lee JH,et al.Relationship between systemic vascular characteristics and retinal nerve fiber layer loss in patients with type 2 diabetes.Sci Rep 2018;8(1):10510
9 Desmettre TJ,Mordon SR,Buzawa DM,et al.Micro pulse and continuous wave diode retinal photoeoagulation:visible and subvisible lesion parameters.Br J Ophthalmol 2006;90(6):709-712
10 Park YR,Jee D.Changes in peripapillary retinal nerve fiber layer thickness after pattern scanning laser photocoagulation in patients with diabetic retinopathy.Korean J Ophthalmol 2014;28(3):220-225
11 Shi R,Guo Z,Wang F,et al.Alterations in retinal nerve fiber layer thickness in early stages of diabetic retinopathy and potential risk factors.Curr Eye Res 2018;43(2):244-253
12 Hernndez C,Dal Monte M,SimóR,et al.Neuroprotection as a therapeutic target for diabetic retinopathy.J Diabetes Res 2016;2016:9508541
13 Takamura Y,Arimura S,Miyake S,et al.Panretinal photocoagulation using short-pulse laser induces less inflammation and macular thickening in patients with diabetic retinopathy.J Ophthalmol 2017;2017:8530261
2 Ciudin A,Hernández C,SimóRI.Iron overload in diabetic retinopathy:A cause or a consequence of impaired mechanisms?Exp Diabetes Res 2010;2010:714108
3陈家欣,吴瑜瑜.全视网膜光凝术对糖尿病视网膜病变视网膜神经纤维层及黄斑视网膜的影响.眼科新进展2015;35(4):380-383
4 Lim MC,Tanimoto SA,Fuflani BA,et al.Effect of diabetic retinopathy and paurefinal photocoagulation on retinal nerve fiber layer and optic nerve appearance.Arch Ophthalmol 2009;127(7):857-862
5 Kim HY,Cho HK.Peripapillary retinal nerve fiber layer thickness change after panretinal photocoagulation in patients with diabetic retinopathy.Korean J Ophthalmol 2009;23(1):23-26
6 The Diabetic Retinopathy Study Research Group.Photocoagulation treatment of proliferative diabetic retinopathy.Clinical application of Diabetic Retinopathy Study(DRS)findings,DRS Report Number 8.Ophthalmology 1981;88(7):583-600
7 Yazdani S,Samadi P,Pakravan M,et al.Peripapillary RNFL thickness changes after panretinal photocoagulation.Optom Vis Sci 2016;93(9):1158-1162
8 Jeon SJ,Park HL,Lee JH,et al.Relationship between systemic vascular characteristics and retinal nerve fiber layer loss in patients with type 2 diabetes.Sci Rep 2018;8(1):10510
9 Desmettre TJ,Mordon SR,Buzawa DM,et al.Micro pulse and continuous wave diode retinal photoeoagulation:visible and subvisible lesion parameters.Br J Ophthalmol 2006;90(6):709-712
10 Park YR,Jee D.Changes in peripapillary retinal nerve fiber layer thickness after pattern scanning laser photocoagulation in patients with diabetic retinopathy.Korean J Ophthalmol 2014;28(3):220-225
11 Shi R,Guo Z,Wang F,et al.Alterations in retinal nerve fiber layer thickness in early stages of diabetic retinopathy and potential risk factors.Curr Eye Res 2018;43(2):244-253
12 Hernndez C,Dal Monte M,SimóR,et al.Neuroprotection as a therapeutic target for diabetic retinopathy.J Diabetes Res 2016;2016:9508541
13 Takamura Y,Arimura S,Miyake S,et al.Panretinal photocoagulation using short-pulse laser induces less inflammation and macular thickening in patients with diabetic retinopathy.J Ophthalmol 2017;2017:8530261