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目的 观察激光诱导脉络膜视网膜静脉吻合术治疗视网膜静脉阻塞 (retinal vein occlusion,RVO)的临床疗效。 方法 RVO患者 2 8例 2 8只眼 ,其中非缺血型组 18例 18只眼 ,采用氪红激光诱导脉络膜视网膜静脉吻合 ;缺血型组 10例 10只眼 ,氪红激光诱导脉络膜视网膜静脉吻合的同时行激光格子样或播散性光凝。术后每 1～ 2周复查 1次视力、眼底 ,术后 2～ 3个月复查荧光素眼底血管造影 (fundusfluorescein angiography,FFA) ,随访 5个月以上。 结果 18只非缺血型 RVO眼中有 7只眼形成脉络膜视网膜静脉吻合 ,占 38.9% ,7只眼最佳矫正视力提高 (4 .43± 0 .78)行 ,未建立吻合的 11只眼最佳矫正视力降低 (0 .19± 0 .6 7)行 ,二者比较差异有显著性意义 (P<0 .0 0 1)。随访时间内 ,未建立吻合的 11只眼中有4只眼发展为缺血状态 ,占 36 .4%。 10只缺血型 RVO眼中有 2只眼形成脉络膜视网膜静脉吻合 ,占 2 0 .0 % ,视力提高 6行 ;未形成吻合者 ,治疗前后视力没有改变 (P>0 .0 5 )。 结论 激光诱导脉络膜视网膜静脉吻合术是治疗 RVO的一种新的有效疗法 ,尤其适用于非缺血型 RVO患者 ,成功的吻合可防止其发展至缺血状态。
Objective To observe the clinical efficacy of laser-induced chorioretinal venous anastomosis in the treatment of retinal vein occlusion (RVO). Methods A total of 28 eyes of 28 patients with RVO were enrolled in this study. Eighteen patients (18 eyes) with nonischemic group were induced by krypton red laser to induce choroidal retinal vein anastomosis. In 10 patients with ischemia group, 10 eyes were treated with krypton red laser to induce choroidal retinal vein Concurrent at the same time laser lattice like or disseminated photocoagulation. Visual acuity and fundus examination were performed every 1 to 2 weeks after operation. Fundus fluorescein angiography (FFA) was performed 2 to 3 months after the operation. The patients were followed up for more than 5 months. Results Seven eyes of 18 non-ischemic RVO eyes formed choroidal retinal vein anastomosis, accounting for 38.9%. Seven eyes had the best corrected visual acuity (4.43 ± 0.78), and no anastomosis of 11 eyes Good corrected visual acuity decreased (0.19 ± 0.67) line, the difference was significant (P <0. 001). During follow-up, 4 eyes of 11 eyes that did not establish an anastomosis developed ischemic status, accounting for 36.4%. Two eyes of 10 ischemic RVO eyes formed choroidal retinal vein anastomosis, accounting for 20.0%, visual acuity increased by 6 lines; no anastomosis was found, visual acuity was not changed before and after treatment (P> 0.05). Conclusion Laser-induced chorioretinal venous anastomosis is a new and effective therapy for RVO. It is especially suitable for non-ischemic RVO patients. Successful anastomosis can prevent its development to ischemic state.