简介:AIM:Tofindouttheoutcomeoflaserphotocoagulationinclinicallysignificantmacularedema(CSME)byopticalcoherencetomography(OCT).·METHODS:Itwasaprospective,non-controlled,caseseriesstudyenrolling81eyesof64patientswithCSMEbetweenAugust2008andJanuary2010.AllpatientsreceivedmodifiedgridphotocoagulationwithfrequencydoubledNd:YAGlaser.Eachpatientwasevaluatedintermsofbest-correctedvisualacuity(BCVA)andregressionorprogressionofmaculopathyafterlasertherapyat1,3and6months.Spearman’scorrelationtestwasusedtoshowthecorrelationbetweenBCVAandtotalmacularvolume(TMV).Analysisofvariance(ANOVA)wasusedtocompareamonggroupsandindependentt-testwasusedtocompareineachgroup.·RESULTS:ThereishighcorrelationbetweenBCVAandTMV(P≤0.001).BCVAimprovedin50.6%,remainedstaticin39.5%anddeterioratedin9.9%patientsafter6monthoftreatment.TheBaselineTMV(meanandSD)were9.26±1.83,10.4±2.38,11.5±3.05,8.89±0.75and9.47±1.98mm3fordifferentOCTpatterns,ST(spongelikethickening),CMO(cystoidmacularedema),SFD(subfovealdetachment),VMIA(Vitreomacularinterfaceabnormality)andaverageTMVrespectively(P=0.04).After6monthsoflasertreatment,themeanTMVdecreasedfrom9.47±1.98mm3to8.77±1.31mm3(P=0.01).InSTtherewassignificantdecreaseinTMV,P=0.01,Furtherwithinthesegroupsat6months,theyweresignificantlydifferent,P=0.01.·CONCLUSION:OCTshowedthedifferentmorphologicalvariantofCSMEwhiletheresponseoftreatmentisdifferent.TMVdecreasedthemostandhenceshowedtheimprovementinvisionafter6monthsoflasertreatment.IntheeraofAntivascularendothelialgrowthfactors(VEGFs),efficacyoflaserseemstobeinshadowbutitisstillfirstlineoftreatmentindevelopingnationlikeNepalwhereantiVEGFsmaynotbeeasilyavailableandaffordable.
简介:中国教育史上曾有不少教育家,对于“学”和“疑”的关系,做了辩证的论述,从一个侧面反映了人们认识的发展规律,今天读来,仍觉很有启示。北宋的张载曾讲:“学则须疑”,“于不疑处有疑,方是进矣。”