玻璃体切割联合眼内全视网膜光凝对PDR合并虹膜新生血管的视网膜供血影响
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Retinal blood supply changes after vitrectomy combined with panretinal photocoagulation in PDR patients with anterior segment neovascularization
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    摘要:

    目的:探讨玻璃体切割联合眼内全视网膜光凝对增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)合并虹膜新生血管(iris neovascularization,NVI)患者视网膜供血的影响及其临床价值。

    方法:采用彩色多普勒超声血流显像技术(color doppler flow imaging,CDFI)检测21例21眼PDR合并NVI患者行玻璃体切割联合眼内光凝术前、术后3mo视网膜中央动脉(central retinal artery,CRA)、睫状后短动脉(shot posterior ciliary artery,sPCA)、眼动脉(ophthalmic artery,OA)的收缩期峰值流速(peak systolic velocity,PSV)、舒张末期血流速度(end diastolic velocity,EDV)、阻力指数(resistance index,RI)的变化。

    结果:玻璃体切割联合眼内全视网膜光凝术后3mo CRA的PSV、EDV较术前明显升高,而RI值下降,有统计学差异(P<0.05)。sPCA及OA各项血流参数手术前后改变无统计学差异(P>0.05)。

    结论:玻璃体切割联合眼内光凝可以提高PDR合并NVI患者术后CRA的血流速度,降低远端视网膜血管的RI,改善眼视网膜的血液供应,延缓或阻止患者向新生血管性青光眼(NVG)的发展与发生。

    Abstract:

    AIM: To investigate hemodynamic alterations of retrobulbar vessels in proliferative diabetic retinopathy(PDR)patients with anterior segment neovascularization, before and 3mo after vitrectomy combined with panretinal photocoagulation and to explore the clinical significance.

    METHODS: Color Doppler flow imaging(CDFI)was used for measurement of blood flow velocities and resistive indexes(RI)of the ophthalmic artery(OA), short posterior ciliary arteries(sPCA)and central retinal artery(CRA)in 21 eyes of 21 PDR patients with anterior segment neovascularization. CDFI parameters were obtained before and 3mo after vitrectomy combined with panretinal photocoagulation(PRP).

    RESULTS: Peak systolic velocity(PSV)and end diastolic velocity(EVD)of CRA were significantly increased after surgeries, RI were decreased significantly(P<0.05). Parameters of sPCA and OA have no change after surgeries(P>0.05).

    CONCLUSION: Vitrectomy combined with panretinal photocoagulation might increase the velocity of CRA, decrease RI and improve ocular blood supply postoperatively. It may delay or prevent the process of neovascular glaucoma.

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王勇,石兴东,胡博杰,等.玻璃体切割联合眼内全视网膜光凝对PDR合并虹膜新生血管的视网膜供血影响.国际眼科杂志, 2016,16(10):1894-1897.

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  • 收稿日期:2016-06-23
  • 最后修改日期:2016-09-01
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  • 在线发布日期: 2016-09-19
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