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[摘要]
目的:观察早期视网膜激光光凝(PRP)联合复方樟柳碱颞浅动脉旁皮下注射治疗放射性视网膜病变(RR)的临床疗效。 方法:在我院确诊为因鼻咽癌外照射后发生RR的患者21例41眼,早期行双眼视网膜激光光凝联合复方樟柳碱颞浅动脉旁穴位注射治疗,观察治疗后3mo最佳矫正视力(BCVA)、毛细血管无灌注区变化、视网膜新生血管及并发症情况。 结果:治疗后观察3mo,视力提高6眼(14.6%),视力不变31眼(75.7%),下降4眼(9.7%)。2眼虹膜新生血管消退,1眼行睫状体光凝术;9眼(75%)视网膜新生血管消退;22眼(68.7%)原视网膜无灌注区消失, 7眼(21.8%)原视网膜无灌注区(NPA)缩小>5个DA,总有效率905%。1眼发生玻璃体出血,未见视盘及虹膜新生血管和新生血管性青光眼等并发症以及与治疗相关的并发症。 结论:早期PRP与复方樟柳碱颞浅动脉旁穴位注射治疗是有效的、合理的中西医结合治疗方法。
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[Abstract]
AIM:To observe the combined curative effect of early panretinal photocoagulation (PRP) and compound anisodine para-temporal-superficial artery injection for radiation retinopathy(RR). METHODS:Twenty-one patients (41 eyes ) with RR in our hospital received early PRP and compound anisodine para-temporal-superficial artery injection. The visual acuity, capillary nonperfusion, retina-neovascularization, and complications at 3 months after treatment were observed. RESULTS:Three months after the treatment, visual acuity were increased in 6 eyes (14.6%) , steady in 31 eyes (75.7%) , decreased in 4 eyes (9.7%) . Iridal neovascularization regressed in 2 eyes, while the other one received the cyclophotocoagulation. Primary retinal neovascularization regressed in 9 eyes (75%), and primary retinal nonperfusion disappeared in 22 eyes (687%), primary retinal nonperfusion shrinked more than five disc area in 7 eyes (21.8%), the total effective rate was 90. 5%. Only one eye developed vitreous hemorrhage,however, no optic disc and iridal neovascularization, and neovascular glaucoma were observed; no complication related with the treatment appeared in all patients. CONCLUSION:Early PRP and compound anisodine para-temporal-superficial artery injection is effective and reasonable integrated traditional and western medicine treatment for radiation retinopathy.
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