再度审视激光光凝在视网膜血管疾病治疗中的价值

摘要

Macular edema is a common cause of visual loss in patients with retinal vascular diseases represented by diabetic retinopathy and retinal vein occlusion.Laser photocoagulation has been the main treatment for this kind of diseases for decades.With the advent of antagonist of vascular endothelial growth factor and dexamethasone implant,diabetic macular edema and macular edema secondary to retinal vein occlusion have been well controlled;the use of laser therapy is decreasing.However,considering possible risks and complications,lack of extended inspection of efficacy and safety of intravitreal pharmacotherapy,laser therapy cannot be replaced by now.Therefore,the efficacy and safety of laser therapy will improve by sober realization of role of photocoagulation and proper selection of treatment indication.%黄斑水肿是引起以糖尿病视网膜病变和视网膜静脉阻塞为代表的视网膜血管疾病患者视力下降的常见原因.激光光凝在过去几十年中一直是该类疾病的主要治疗方法.近年来随着抗血管内皮生长因子药物和类固醇激素缓释剂等新型眼内药物的应用,使得糖尿病黄斑水肿和继发于视网膜静脉阻塞的黄斑水肿得以较好的控制,导致传统激光光凝治疗适应证范围逐渐缩小.但值得注意的是,目前眼内药物的治疗存在可能的风险和并发症,其治疗效果和安全性还需要更长期的验证,仍无法完全替代激光光凝.新型激光的出现,在同样有效的治疗基础上,更有可能减少视网膜损伤.因而,应再度审视激光光凝在视网膜血管疾病治疗中的价值,合理选择适应证,提高其安全性和有效性.