玻璃体腔注射曲安奈德治疗糖尿病性黄斑水肿  

Intravitreal triamcinolone for the treatment of diabetic macular edema

作　　者：王丽丽[1] 宋虎平[2] 王海燕[2] 朱忠桥[1] 薛晓辉[1] 王睿[1] 黄玲[1] 

机构地区：[1]西安市第四医院,西安710004 [2]第四军医大学西京医院眼科

出　　处：《中国实用眼科杂志》2006年第11期1178-1180,共3页Chinese Journal of Practical Ophthalmology

基　　金：陕西省科技攻关项目资金2005K-14G6

摘　　要：目的探讨玻璃体腔注射曲安奈德(intravitrealtriamcinoloneacetonide,IVTA)治疗糖尿病性黄斑水肿(diabeticmacularedema,DME)的疗效。方法回顾性分析25例(28只[)糖尿病性黄斑水肿患者,采用IVTA治疗,剂量为4mg/0.1ml。对比分析治疗前后视力,[压及黄斑区视网膜厚度变化。平均随访6个月。统计学方法采用SPSS13.0软件对各组数据进行处理(秩和检验、配对t检验)。结果治疗后1个月、3个月、6个月,平均视力由术前0.08±0.04分别提高到0.15±0.12、0.16±0.13、0.14±0.12,与治疗前比较差异有统计学意义(P<0.001)。OCT检查黄斑视网膜厚度术前平均为(599.89±135.65)μm,治疗后各时点分别为(249.70±74.69)μm、(243.18±73.19)μm和(245.54±69.33)μm。与治疗前比较有显著性差异(P<0.001)。5只[(17.9%)接受2次IVTA,第一、二次注药时间平均间隔为3个月。9只[(32.1%)[压升高(>21mmHg),局部或全身应用降[压药,[压均能控制正常。结论IVTA是治疗DME的有效方法,能有效改善黄斑水肿和提高视力,降低黄斑区视网膜厚度,但部分黄斑水肿复发,出现一过性[压升高,需进一步观察其长期疗效和安全性。Objective To investigate the efficacy of intravitreal triamcinolone acetonide （IVTA） for the treatment of diabetic macular edema （DME）, Method 28 eyes in 25 patients with DME underwent intravitreal injection of triamcinolone acetonide with 0.1ml（4mg）. Best-corrected visual acuity, intraocular pressure and central macular thickness were performed on the patients before and after the injection. The follow-up period was mean 6 months. Statistical analyses were performed by SPPS 13. Results The average visual acuity was 0.08 ± 0.04 before the treatment; while 1, 3 and 6 months after the injection, mean visual acuity improved 0.15 ± 0.12, 0.16 ± 0.13 and 0.14 ± 0.12, which had statistical significance compared with that before the treatment （P 〈0.001）; The average retinal thickness at macular thickness decreased from （599.89 ± 135.65） μm to （249.70 ± 74.69）μm, （243.18 ± 73.19） μm and （245.54 ± 69.33）μm. which had statistical significance compared with that before the treatment （P 〈0.001）. 5eyes （17.9.%） received two IVTA injections. The mean interval between the first and second IVTA injection was 3 months. Intraocular pressure was raised above 21 mmHg in 9 （32.1%） of 28 eyes, and was controlled to normal level after teratment. Conclusions IVTA is effective in improving vision, reducing macular thickness. Further investigation is warranted to assess the safety of IVTA for the treatment of DME.

关 键 词：黄斑水肿 囊样/药物疗法 曲安奈德/治疗应用 糖尿病/并发症 

分 类 号：R587.2[医药卫生—内分泌]