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汎網膜光凝固実施基準の基礎的研究

全视网膜光凝实践标准的基础研究

基本信息

批准号：
02404069
负责人：
松尾信彦
金额：
$ 6.53万
依托单位：
Okayama University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (A)
财政年份：
1990
资助国家：
日本
起止时间：
1990 至 1991
项目状态：
已结题

项目摘要

蛍光眼底写真上,網膜血管閉塞領域を認めない単純型糖尿病性網膜症14例16眼,汎網膜光凝固術を必要とした増殖型糖尿病性網膜症8例13眼を対象とし,同年代の正常者23例31眼を正常群とした汎網膜光凝固術は鼻側領域をはじめとして,耳上側,耳下側の3回に分け,それぞれ1週間の間隔をあけて施行し,鼻側領域の凝固条件は0.25ec,200〜500mw,250〜500umで,鼻側領域の凝固数は235〜407(平均317)であった。各症例に対し,当教室で開発したビデオ蛍光眼底造影と画像解析を利用した方法により網膜全領域の網膜平均循環時間を測定した。ただし汎網膜光凝固術を行った症例では光凝固術後2週,1ヵ月,3ヵ月,6ヵ月の鼻側領域のみを測定した。正常群の網膜平均循環時間は3.17±0.75秒(h=120),単純型糖尿病性網膜症群では2.79±1.16秒(n=61),光凝固術前の増殖型糖尿病性網膜症群では5.78±1.66秒(n=52)であった。これから単純型糖尿病性網膜症眼では正常芽に比べ有意な短縮が認められ(P〈0.03),増殖型糖尿病性網膜症眼では有意な延長が認められた(P〈0.01)。次に光凝固術前・術後の鼻側領域の網膜平均循環時間は,術前:鼻下側5.99±1.51秒,鼻上側5.67±1.40秒,術後2週:鼻下側4.57±0.91秒,鼻上側4.31±0.84秒,術後1ヵ月:鼻下側4.32±0.93秒,鼻上側4.29±0.89秒,術後3ヵ月:鼻下例4.36±0.97秒,鼻上側4.03±0.86秒,術後6ヵ月:鼻下側4.09±0.59秒,鼻上側3.61±0.31秒であり,術前に比べ,すべての術後網膜平均循環時間が有意に短縮した(P〈0.01)。これから汎網膜光凝固術を行うことにより増殖型糖尿病性網膜症眼の網膜平均循環時間が術後比較的早期から知縮することが判明した。なお増殖型糖尿病性網膜症7眼について術後1日では術前に比べ網膜循環時間の有意な延長を認め(P〈0.05),術後2週で有意な短縮を認めた。

14 cases (16 eyes) of pure diabetic retinopathy were identified by fundus photography. Panretinal photocoagulation was necessary in 8 cases (13 eyes) of diabetic retinopathy. 23 cases (31 eyes) of normal subjects in the same age group. Panretinal photocoagulation was performed at intervals of 1 week. Nasal field solidification conditions 0.25ec,200 ~ 500mw,250 ~ 500um, Nasal field solidification number 235 ~ 407(average 317). For each case, when the classroom was opened, the fundus photography and image analysis were used to determine the mean circulation time of the retina in the whole field. The nasal area was measured at 2 weeks, 1 month, 3 months and 6 months after photocoagulation. The mean retinal circulation time was 3.17±0.75 seconds (h=120) in the normal group, 2.79±1.16 seconds (n=61) in the pure diabetic group, and 5.78±1.66 seconds (n=52) in the proliferative diabetic group before photocoagulation. The eyes of pure diabetic retinopathy were significantly shorter than those of normal diabetic retinopathy (P <0.03), while those of proliferative diabetic retinopathy were significantly longer (P <0.01). The mean circulation time of omentum in nasal area before and after photocoagulation was 5.99±1.51 seconds in inferior nasal area and 5.67±1.40 seconds in superior nasal area before photocoagulation, 2 weeks after photocoagulation: 4.57±0.91 seconds at the inferior side of nose, 4.31±0.84 seconds at the superior side of nose, 1 month after operation: 4.32±0.93 seconds at the inferior side of nose, 4.29±0.89 seconds at the superior side of nose, 3 months after operation: 4.36±0.97 seconds in the inferior part of the nose and 4.03 ±0.86 seconds in the superior part of the nose. The mean retinal circulation time was significantly shortened (P <0.01). Retinal mean circulation time in diabetic retinopathy was identified early after surgery. 7 eyes with diabetic retinopathy were found to have prolonged retinal circulation time (P <0.05) 1 day after operation and shortened retinal circulation time (P <0.05) 2 weeks after operation.