Objective To compare the clinical effects of 577 nm and 532 nm laser panretinal photocoagulation in the treatment of severe non-proliferative diabetic retinopathy (NPDR).Methods A prospective,controlled trial was conducted in 42 patients(64 eyes)with severe NPDR,who were randomly divided into 577 nm group and 532 nm group.All of patients received PRP with the single-point model.Preoperative and postoperative 1 day,1 month,3 and 6 months,the best corrected visual acuity (BCVA),fundus,optical coherence tomography (OCT) and full field flash electroretinogram (F-ERG) were examined.After treatment 3 and 6 months,fundus fluorescein angiography (FFA) examination was performed between two groups.Results In 577 nm group and 532 nm group,the average number of laser spot was (1969.25 ± 278.19) and (2098.16 ± 289.27) respectively;average laser power was (425.23 ± 50.15)mW and (438.15 ± 38.48)mW respectively;and average energy density was (7.54 ± 1.54) mW · ms · μm-2 and (7.68 ± 3.01)mW · ms · μm-2.There was no difference in number of laser spot(t =2.68),laser power (t =1.46) and energy density (t =2.15) between the two groups (all P ＞ 0.05),and the differences of macular central thickness after treatment 1 month,3 and 6 months (t =1.98,1.88,1.81 respectively) approached no statistical significance between the two groups (all P ＞ 0.05),while F-ERG a,b wave amplitudes after treatment 1 month,3 and 6 months (a wave:t =5.94,5.19,6.97;b wave:t =5.67,4.56,5.12) had significant differences between groups (all P ＜ 0.05).The effective rate of treating 6 months after operation in the two groups were 87.5％ and 46.9％ respectively,with significant difference (x2 =7.56,P ＜ 0.05).Conclusion 577 nm laser is more effective and has less damage to visual function than 532 nm laser in the treatment of NPDR.%目的 比较577 nm、532 nm激光全视网膜激光光凝(panretinal photocoagulation,PRP)治疗重度非增生型糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)的临床疗效.方法 前瞻性临床对照研究.纳入重度NPDR患者42例64眼,随机分为577 nm组和532 nm组,采用单点模式行PRP,术前及术后1d、1个月、3个月、6个月检查最佳矫正视力(best corrected visual acuity,BCVA)、眼底、光学相干断层扫描(optical coherence tomography,OCT)、全视野闪光视网膜电图(flash electroretinogram,F-ERG),术后3个月、6个月行眼底荧光血管造影(fundus fluorescein angiography,FFA)检查.结果 577 nm组和532nm组光斑点数分别为(1969.25±278.19)点、(2098.16±289.27)点;激光功率分别为(425.23±50.15) mW、(438.15±38.48)mW;能量密度分别为(7.54±1.54)mW· ms-1 · μm-2、(7.68±3.01)mW·ms-1·μm-2,平均光斑数(=2.68)、平均激光功率(t=1.46)、平均能量密度(t=2.15)的组间差异均无统计学意义(均为P＞0.05).两组患者术后1个月、3个月、6个月,组间黄斑中心凹厚度(central macular thickness,CMT)差异均无统计学意义(t=1.98、1.88、1.81,均为P＞0.05);两组患者术后1个月、3个月、6个月F-ERG振幅(a波:f=5.94、5.19、6.97;b波:=5.67、4.56、5.12)组间差异均有统计学意义(均为P＜0.05).术后6个月两组患者治疗有效率分别为87.5％、46.9％,差异有统计学意义(x2=7.56,P＜0.05).结论 577 nm激光比532nm激光治疗重度NPDR有效率更高,视功能损伤程度更小.
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