Ultra Q:YAG激光治疗黄斑部视网膜前出血17例并文献复习

doi:10.6040/j.issn.1673-3770.0.2024.047

摘要/Abstract

摘要： 目的探讨与分析Ultra Q:YAG激光膜切开引流术治疗黄斑部视网膜前出血的疗效。方法回顾性分析17例(17眼)黄斑部视网膜前出血患者,均行Ultra Q:YAG激光膜切开引流术进行治疗,对患者术后随访1个月,观察术后玻璃体腔出血吸收、视力改善、并发症发生情况并分析失败原因。结果 12眼(70.6%)治疗成功,出血均基本吸收,视力均得到明显改善。治疗失败5眼中其中2眼病程超过30 d,2眼出血形态呈不规则多边形,1眼激光膜切开术后1个月玻璃体积血吸收不佳并行玻璃体切割术。结论 Ultra Q:YAG激光治疗黄斑部视网膜前出血有效安全可行。黄斑部视网膜前出血应尽早行Ultra Q:YAG激光治疗以期达到好的治疗效果。

关键词: Ultra Q:YAG激光, 黄斑, 视网膜前出血, 膜切开术, 玻璃体切除术

Abstract: Objective To examine the effectiveness of Ultra Q: YAG laser membranotomy in treating preretinal hemorrhage in the macula. Methods This retrospective study analyzed 17 patients(17 eyes)treated for preretinal hemorrhage in the macula with Ultra Q: YAG laser membranotomy. Patients were followed up one month postoperatively to observe vitreous hemorrhage absorption, visual improvement, complication occurrence, and to identify reasons for unsuccessful outcomes. Results Treatment was successful in 12 out of 17 eyes(70.6%), with complete absorption of hemorrhage and notable visual improvement. Among the five unsuccessful cases, two had a disease duration of over 30 days, two exhibited irregularly shaped hemorrhages, and one showed poor absorption of vitreous hemorrhage one month post-membranotomy, necessitating vitrectomy. Conclusion Ultra Q: YAG laser treatment for preretinal hemorrhage in the macula is proven to be effective, safe, and feasible. Early intervention with Ultra Q: YAG laser is recommended to optimize treatment outcomes.

Key words: Ultra Q: YAG laser, Macula, Preretinal hemorrhage, Membranotomy, Vitrectomy

中图分类号:

R774.5

肖哲,张胜娟,赵子琦,兴辰,李成泉,刘志强. Ultra Q:YAG激光治疗黄斑部视网膜前出血17例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 130-135.

XIAO Zhe, ZHANG Shengjuan, ZHAO Ziqi, XING Chen, LI Chengquan, LIU Zhiqiang. Ultra Q:YAG laser treatment for macular retinal pre-retinal hemorrhage in 17 cases and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 130-135.

参考文献

[1] 邢文锐. 黄斑部视网膜前出血[J]. 中华眼科杂志, 2020, 56(7): 488. doi:10.3760/cma.j.cn112142-20200218-00079
[2] Malek MA, Niyonzima JC, Pathan MAHK, et al. Pars Plana vitrectomy for a sub-internal limiting membrane hemorrhage and vitreous hemorrhage secondary to dengue fever: a case report[J]. Cureus, 2022, 14(6): e25916. doi:10.7759/cureus.25916
[3] Akhavanrezayat A, Cooper JD, Hassan M, et al. Bilateral preretinal hemorrhage associated with Kikuchi-Fujimoto disease[J]. Am J Ophthalmol Case Rep, 2021, 22: 101041. doi:10.1016/j.ajoc.2021.101041
[4] Jaime L, Javier L, Nicolás RV, et al. Nd: YAG membranotomy for sub-inner limiting membrane hemorrhage: a case report[J]. Rom J Ophthalmol, 2021, 65(1): 76-79. doi:10.22336/rjo.2021.15
[5] Hussain Rumana N, Theodor S, Paul H, et al. Histopathological changes and clinical outcomes following intervention for sub-internal limiting membrane haemorrhage[J]. Ophthalmol J Int, 2020, 243(3): 217-223. doi: 10.1159/000502442
[6] 张永鹏, 曹绪胜, 李继鹏, 等. 黄斑部视网膜内界膜下出血行577nm激光膜切开术的临床研究[J]. 中华眼科医学杂志(电子版), 2021, 11(3): 159-165. doi:10.3877/cma.j.issn.2095-2007.2021.03.006 ZHANG Yongpeng, CAO Xusheng, LI Jipeng, et al. Effects of 577 nm laser membranotomy on macular sub-inner limiting membrane hemorrhage[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2021, 11(3): 159-165. doi:10.3877/cma.j.issn.2095-2007.2021.03.006
[7] Quiroz-Mendoza JL, Valera-Cornejo DA, García-Roa M, et al. Different approaches in the management of macular hemorrhage: case reports and a literature review[J]. Medwave, 2020, 20(2): e7831. doi:10.5867/medwave.2020.02.7831
[8] 何海龙, 常笛, 周春媛, 等. 两种Nd: YAG激光后囊膜切开方式治疗后囊膜混浊的Meta分析[J]. 国际眼科杂志, 2020, 20(10): 1764-1768. doi:10.3980/j.issn.1672-5123.2020.10.22 HE Hailong, CHANG Di, ZHOU Chunyuan, et al. Meta-analysis of two kinds of Nd: YAG laser posterior capsulotomy in the treatment opacification[J]. International Eye Science, 2020, 20(10): 1764-1768. doi:10.3980/j.issn.1672-5123.2020.10.22
[9] Tassignon MJ, Stempels N, Van Mulders L. Retrohyaloid premacular hemorrhage treated by Q-switched Nd-YAG laser. A case report[J]. Graefes Arch Clin Exp Ophthalmol, 1989, 227(5): 440-442. doi: 10.1007/BF02172895
[10] 刘小虎, 王国平, 肖建强, 等. Nd: YAG激光联合活血化瘀中药治疗黄斑区内界膜下出血1例[J]. 中医眼耳鼻喉杂志, 2020, 10(2): 116-117. doi:10.3969/j.issn.1674-9006.2020.02.018 LIU Xiaohu, WANG Guoping, XIAO Jianqiang, et al. One case of sub-inner limiting membrane hemorrhage in macular area treated by Nd: YAG laser with traditional Chinese medicine for promoting blood circulation and removing stasis[J]. Journal of Chinese Ophthalmology and Otorhinolaryngology, 2020, 10(2): 116-117. doi:10.3969/j.issn.1674-9006.2020.02.018
[11] 赵玥, 王杨宁致, 王成虎, 等. Ultra Q: YAG与传统Nd: YAG激光对视网膜内界膜下出血患者治疗效果的对比[J]. 眼科新进展, 2020, 40(7): 649-652. doi:10.13389/j.cnki.rao.2020.1149 ZHAO Yue, WANG Yangningzhi, WANG Chenghu, et al. Comparison of ultra Q: YAG and traditional Nd: YAG laser for patients with sub-inner limiting membrane hemorrhage[J]. Recent Advances in Ophthalmology, 2020, 40(7): 649-652. doi:10.13389/j.cnki.rao.2020.1149
[12] Gutiérrez-Montero O, Reche-Sainz JA. Recurrent pre-retinal haemorrhages associated with coagulation factor VII deficiency[J]. Arch Soc Esp Oftalmol(Engl Ed), 2019, 94(8): 409-412. doi:10.1016/j.oftal.2019.04.005
[13] 周芬, 蒋沁, 姚进. Nd:YAG激光治疗视网膜内界膜下出血的临床疗效[J]. 中国激光医学杂志, 2024, 33(2): 72-75, 119-120. doi:10.13480/j.issn1003-9430.2024.0072 ZHOU Fen, JIANG Qin, YAO Jin. Efficency of Nd: YAG laser membranotomy in treatment of sub-internal limiting membrane hemorrhage[J]. Chin J Laser Med Surg, 2024, 33(2):72-75, 119-120. doi:10.13480/j.issn1003-9430.2024.0072
[14] Oscar K, Metasebia M, Manthan S, et al. Nd:YAG membranotomy for preretinal hemorrhage secondary to valsalva retinopathy[J]. Saudi journal of ophthalmology, 2014, 28:145-151
[15] Mansour A. Nd: YAG laser photodisruption of hemorrhagic detachment of the internal limiting membrane[J]. Am J Ophthalmol, 1989, 107(5): 566-567. doi:10.1016/0002-9394(89)90519-9
[16] Ulbig MW, Mangouritsas G, Rothbacher HH, et al. Long-term results after drainage of premacular subhyaloid hemorrhage into the vitreous with a pulsed Nd: YAG laser[J]. Arch Ophthalmol, 1998, 116(11): 1465-1469. doi:10.1001/archopht.116.11.1465
[17] Durukan AH, Kerimoglu H, Erdurman C, et al. Long-term results of Nd: YAG laser treatment for premacular subhyaloid haemorrhage owing to Valsalva retinopathy[J]. Eye, 2008, 22(2): 214-218. doi:10.1038/sj.eye.6702574
[18] 田芳, 王润生. Nd: YAG激光光凝引流黄斑区视网膜前陈旧性出血一例[J]. 中华眼底病杂志, 2014, 30(3): 319-320. doi:10.3760/cma.j.issn.1005-1015.2014.03.026
[19] Khadka D, Bhandari S, Bajimaya S, et al. Nd: YAG laser hyaloidotomy in the management of Premacular Subhyaloid Hemorrhage[J]. BMC Ophthalmol, 2016, 16: 41. doi:10.1186/s12886-016-0218-0
[20] Karagiannis D, Kontadakis GA, Flanagan D. ND: YAG laser for preretinal hemorrhage in diabetic retinopathy[J]. Am J Ophthalmol Case Rep, 2018, 10: 8-9. doi:10.1016/j.ajoc.2018.01.027

相关文章 15

[1]	沈嘉琪,李潇飒,毕燕龙,张敬法. 人工智能在DME筛查、诊断和预后中的应用[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 153-159.
[2]	鲍莹,刘志高,姜鹏飞,崔文轩,郑晓霞,杨梦瑶,司明威,王玉,王红. 康柏西普治疗糖尿病合并CRVO-ME高反射点的临床观察[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 55-60.
[3]	常威威,焦万珍,崔艳艳,赵杰,刘兆强,赵博军. 糖尿病性黄斑缺血的研究进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 130-136.
[4]	周静琳,李金香,曾琦. 577 nm阈值下微脉冲激光联合抗VEGF药物治疗难治性糖尿病性黄斑水肿的疗效观察[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 18-25.
[5]	何静,雷春燕,张美霞. 糖化血红蛋白变异指数与糖尿病视网膜病变严重程度的相关性研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 34-40.
[6]	张晓晗,魏丽,杨凯莉,陈海燕,李彦松,王平. 中医辨证论治前后CSC患者OCTA变化及其与视力的相关性研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 115-122.
[7]	周加敏,宋玉婉,孙岩. 细胞焦亡在老年退行性疾病中的研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 172-180.
[8]	赵露,田慧文,孟博,王薇,王艳玲. 颈内动脉闭塞患者黄斑区视网膜脉络膜厚度变化分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 72-76.
[9]	徐恩沛,孙先勇. 渗出性年龄相关性黄斑变性并发视网膜色素上皮脱离的诊治进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 125-142.
[10]	孟博,王康,罗丽华,王艳玲,李爽. 基于WOS数据库的高度近视黄斑裂孔性视网膜脱离研究特征及趋势分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 84-90.
[11]	雷敏,陈婷,艾明. 特发性黄斑前膜患者神经节细胞复合体厚度与黄斑部深浅血流密度比值的相关性研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 104-113.
[12]	李鹏伟,苏光明,刘江川,穆雅林. 光学相干断层扫描血管成像在2型黄斑毛细血管扩张症中的应用进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 140-144.
[13]	李曼,王艳玲,赵露. 白内障术后粪肠球菌眼内炎1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 56-59.
[14]	王露萍,寇芳柠,王皓,张灿伟,王艳玲,尤冉,吴伟珍. 视网膜下高反射物质在抗VEGF治疗nAMD患者中对视力预后的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 101-105.
[15]	顾冉冉,李凤娇,焦万珍,崔艳艳,赵博军. 卵磷脂络和碘胶囊辅助治疗视网膜静脉阻塞的临床疗效研究[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 46-50.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed