Evaluation of prospective clinical research on aptitude for photocoagulation therapy of diabetic retinopathy

为评价光凝治疗增殖期前糖尿病视网膜病变的时机和方法，对随机前瞻性临床试验后36个月的治疗组和未治疗组进行比较。49只中重度增殖期糖尿病视网膜病变患者随机分为两组，治疗组23只眼，未治疗组26只眼，治疗组12只眼，非治疗组20只眼，随访36个月以上。治疗组在试验开始时对荧光素血管造影(FAG)检测到的非灌注区进行选择性光凝。当非灌注区进展时进行附加凝血，并在选择性凝血后进行定期检查。未治疗组在每隔6个月行FAG检测新生血管(NV)时进行分散凝血，36个月时治疗组有2只眼发生新生血管，未治疗组有12只眼发生新生血管(P=0.02)。比较治疗前和治疗后36个月的视力，治疗组视力下降2行以上(p=0.047)，未治疗组视力无下降。建议对中度增殖性前期糖尿病视网膜病变进行光凝治疗，以防止增殖性糖尿病视网膜病变的进展。

To evaluate the efficacy of timing and method of photocoagulation for pre-proliferative diabetic retinopathy, treated group and non-treated group were compared at 36 months after randomized prospective clinical trial.Forty nine eyes were involved in the study with moderately severe pre-proliferative diabetic retinopathy and randomly divided into two groups; 23 eyes for treated group and 26 for non-treated, the eyes followed more than 36 months were 12 in the treated eyes and 20 in the non-treated eyes. In the treated group, selective photocoagulation was performed at the beginning of the trial to the non-perfused areas detected by fluorescein angiography (FAG). Additional coagulation was performed when the non-perfused area was progressed and detected at periodical examinations after the selective coagulation. In the non-treated group, scattered coagulation was performed when the neovascularization (NV) was detected by FAG at every 6-months examination.At 36 months, 2 eyes developed NV in the treated group whereas 12 eyes in the non-treated group (p=0.02). When the visual acuity was compared between the baseline and at 36months, it reduced more than 2 lines in the treated group (p=0.047) and no reduction of visual acuity was noted in the non-treated group.The photocoagulation was recommended for the moderately severe pre-proliferative diabetic retinopathy to prevent progression of proliferative diabetic retinopathy.