视网膜分枝静脉阻塞的激光治疗时机选择

目的：分析视网膜分枝静脉阻塞不同发病阶段的激光治疗疗效，为临床治疗时机选择提供依据。方法：按发病时间将患者分为病程短于3个月但长于1个月的A组(20例)及病程大于3个月的B组(29例)，两组采用象限联合后极部格栅样光凝法。记录两组的阻塞部位、激光前后视力、眼部新生血管、黄斑病变的转归及光凝次数和光斑点数。结果：两组在静脉阻塞部位分布、激光次数和光凝点数方面均无显著差异；光凝后两组视力均得到提高，B组基础视力较A组好约1行；B组光凝前眼底新生血管总发病率为51．7％，A组为0；光凝后B组新生血管消退率为80％；光凝后A组和B组黄斑水肿的好转率分别为80％和91．7％。两组均未见明显的并发症。结论：在能保证随访的情况下优先对患者观察，如眼底出现新生血管或出血淡化则予以光凝；如随访不便，在病程1～3个月之间光凝同样是有利和安全的。

Time selection of laser treatment for branch retinal vein occlusion

objective:analysing the therapeutic effect of laser treatment in the different phase of branch retinal vein occlusion (brvo) for the purpose of offering strategic time option of treatment.methods:patients were divided into two subgroups according to onset history,those with history longer than 1 month and less than 3 months were assigned to group a(20 cases),while those longer than 3 months to group b (29 cases).all patients were treated with scatter and grid laser photocoagulation.the site of occlusion,total laser burns and visual acuity(va),neovascularization (nv),maculopathy before and after treatment were recorded.results:there were no significant difference on the site of occlusion and laser burns between two groups.the va were enhanced after treatment in both groups while the baseline va in group b was 1 line better than that in group a.total incidence of fundus nv before treatment in group b was 51.7% as opposed to 0 in group a.80% nv obliterated after treatment in group b.the total resolution and alleviation rate of macular edema was 80% and 91.7% in group a and b respectively.conclusion:close observation should be implemented firstly if patient can follow up timely and instant photocoagulation be given as soon as the finding of nv or fundus hemorrhage become dissipating.if timely follow-up was impossible,laser treatment given between 1 and 3 months after onset is also beneficial and safe to the patients.