阈值下微脉冲激光光凝作用机制及临床应用

doi:10.6040/j.issn.1673-3770.0.2022.254

摘要/Abstract

摘要： 阈值下微脉冲激光(subthneshold diode micropulse loser, SDML)是短时间内多次发射阈值下不连续的多个重复的能量脉冲的激光,目前可用于糖尿病视网膜病变、中心性浆液性脉络膜视网膜病变以及视网膜静脉阻塞继发的黄斑水肿等视网膜疾病中。与传统的激光相比较,SDML可更好地保留患者的视觉对比敏感度,减少视网膜下纤维化以及瘢痕形成等风险。目前的研究表明,其可以选择性的作用于视网膜色素上皮细胞、修复Müller细胞的功能、使小胶质细胞失活以及能降低血管内皮生长因子等炎症因子的表达以及上调色素上皮衍生因子等保护因子的表达等来抑制新生血管的形成并减轻黄斑水肿,从而达到保护视网膜功能,挽救患者视力的目的。但目前在临床运用中尚存在SDML治疗能量、时间、密度等参数未标准化以及分子机制未完全阐明等问题,因此仍旧需要更多的临床试验以及基础实验的研究。论文旨在对SDML的分子机制及其目前的临床应用进行综述,以期能为SDML在临床的应用提供参考。

关键词: 阈值下微脉冲激光, 分子机制, 临床应用, 糖尿病视网膜病变, 中心性浆液性脉络膜视网膜病变, 视网膜静脉阻塞

Abstract: The subthreshold diode micropulse laser(SDML)is a multiple repeated energy micropulse emitted by multiple thresholds within a short time. Currently, it can be used in retinal diseases, such as diabetic retinopathy, central serous chorioretinopathy, and retinal vein occlusion macular edema. The SDML can preserve the visual contrast sensitivity better than the traditional laser, reducing the risks of subretinal fibrosis and scar formation. The current research shows that it can selectively act on the retinal pigment epithelial, improve the function of Müller cells, inactivate microglia, reduce the expression of inflammatory factors such as the vascular endothelial growth factor, and up-regulate the expression of protective factors such as the pigment epithelium-derived factor to inhibit the formation of neovascularization and reduce macular edema to protect retinal function and preserve patients' vision. However, problems still exist in its clinical applications, such as the nonstandardization of the energy, time, density, and other parameters of SDML treatment and the unclear molecular mechanism. Therefore, further clinical trials and basic experimental studies are required. The purpose of this study is to review the molecular mechanism and current clinical applications of SDML to provide a reference for the clinical applications of SDML

Key words: Subthreshold diode micropulse laser, Molecular mechanism, Clinical application, Diabetic retinopathy, Central serous chorioretinopathy, Retinal vein occlusion

中图分类号:

R774.1

唐慧新,李景景,邹红. 阈值下微脉冲激光光凝作用机制及临床应用[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 143-148.

TANG Huixin, LI Jingjing, ZOU Hong. Mechanism and clinical applications of subthreshold diode micropulse laser[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 143-148.

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