[关键词]
[摘要]
靶向视网膜光凝(TRP)即靶向光凝视网膜无灌注区(NPA)，这一激光模式可以大幅降低全视网膜光凝(PRP)的并发症风险。超广角荧光素血管造影(UWFFA)可以清晰显示远周边部视网膜NPA，有利于TRP的精确定位与实施。目前，针对增殖性糖尿病视网膜病变(PDR)的TRP治疗方案短期安全性较好，但其长期疗效尚不确切。未来，TRP可能成为部分PDR患者的早期治疗选择，通过推迟PRP以维持视敏度及中心视野。抗血管内皮生长因子(VEGF)药物是目前治疗糖尿病性黄斑水肿(DME)的一线用药，对合并视网膜新生血管(NV)或依从性差的DME患者可考虑联合TRP治疗。缺血指数(ISI)用于量化分析UWFFA视野下的视网膜NPA，未来有望成为重要参考指标，指导临床TRP治疗方案的选择。
[Key word]
[Abstract]
Targeted retinal photocoagulation(TRP)refers to targeted photocoagulation of the non-perfusion areas(NPA)of the retina, which can greatly reduce the risk of complications of panretinal photocoagulation(PRP). Ultra-wide field fluorescein angiography(UWFFA)can clearly show NPA of the far peripheral retina, which is conducive to precise positioning and implementation of TRP therapy. At present, the safety of short-term TRP treatment programs for proliferative diabetic retinopathy(PDR)is reasonable, but the long-term efficacy is still uncertain. In the future, TRP may become an early treatment option for some PDR patients, by delaying PRP to maintain the visual acuity and central field of vision. Anti-vascular endothelial growth factor(VEGF)drugs are currently the first-line drugs for diabetic macular edema(DME), for which with retinal neovascularization(NV)or poor compliance, combined TRP therapy may be considered. The ischemic index(ISI)is used to quantitatively analyze NPA of the retina under the vision of UWFFA, which is expected to become an important index in the future to guide the selection of clinical TRP treatment options.
[中图分类号]
[基金项目]
国家自然科学基金青年基金项目(No.81500744)
