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目的 分析 317例 5 97只眼糖尿病黄斑病变荧光形态并进行分型 ,探讨类型和分期与视力预后的关系。方法 每例均作双眼荧光素眼底血管造影 ,分析黄斑区荧光素渗漏的来源 ,形态和范围。黄斑拱环的大小及黄斑区是否有无灌注区存在 ,有无增生等。 结果 ① 5 97只眼中无渗漏型 15 4只眼占 2 5 .8,局部水肿型 188只眼占 31.5 % ,弥漫水肿型 2 39只眼占 40 .0 % ,缺血型 12只眼占 2 .0 % ,增生型 4只眼占0 .7% ;②视力预后与分型有密切关系。以视力大于或等于 0 .5计 ,无渗漏型占 99.4% ,局部水肿型占 83 .0 % ,弥漫水肿型占 2 8.4% ,缺血型占 8.4% ,增生型无 1只眼在 0 .5以上。黄斑囊样水肿占 2 0 .3 %。③分期与视力预后 ,随期数愈高视力预后愈差 ,视力大于或等于 0 .5者 ,1期占 96 .2 % ,2期占 84.8% ,3期占 5 3 .2 % ,4期占 37.2 % ,5期占 12 .5 %。结论 糖尿病黄斑病变是导致糖尿病患者视力减退的重要因素 ,不同分型有不同的预后 .黄斑水肿和囊样水肿应作激光治疗以阻止视力下降。
Objective To analyze and classify the fluorescence patterns of 317 patients with macular degeneration in 5797 eyes and discuss the relationship between the type and stage and the prognosis of vision. Methods All cases were made binocular fluorescein fundus angiography, the source of macular fluorescein leakage, morphology and scope. The size of the macular arch and macular area whether there is no perfusion area, with or without proliferation. Results ① Fifty-seven eyes had no leakage 15 4 eyes accounted for 25.8%, partial edema 188 eyes accounted for 31.5%, diffuse edema 291 eyes 40.0%, and ischemic 12 eyes 2. 0%, 4 eyes accounted for 0.7% of proliferative; ② visual acuity prognosis and classification are closely related. With a visual acuity greater than or equal to 0.5, no leakage accounted for 99.4%, local edema accounted for 83.0%, diffuse edema accounted for 8.42%, ischemic accounted for 8.4%, hyperplastic no eyes in 0 .5 above. Cystoid macular edema accounted for 20.3%. ③ staging and vision prognosis, with the higher the worse the prognosis of vision worse, visual acuity greater than or equal to 0.5, a period of 96.2%, 2 84.8%, 3 3 5.2%, 4 Accounting for 37.2% and 5 accounting for 12.5%. Conclusion Diabetic maculopathy is an important factor leading to diabetic patients with vision loss, and different types have different prognosis. Macular edema and cystoid edema should be laser treatment to prevent vision loss.