曲安奈德玻璃体注射治疗视网膜中央静脉阻塞继发黄斑水肿  

Intravitreal triamcinolone acetonide for the treatment ofmacular edema associated with central retinal vein occlusion

作　　者：李宇军[1] 车廷华[1] 霍虹[1] 

机构地区：[1]黑龙江省医院道外院区眼科,哈尔滨150056

出　　处：《中国实用眼科杂志》2008年第4期337-339,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察玻璃体腔曲安奈德注射（intravitreal triamcinolone acetonide, IVTA ）治疗视网膜中央静脉阻塞（central retinal vein occlusion，CRVO）继发的黄斑水肿的近期疗效和并发症。方法对30例（30只眼）CRVO继发的严重黄斑水肿患者，患眼行IVTA 4ms／0．1ml，观察治疗前和治疗后1d、3d、1周、1个月、3个月时患者的最佳矫正视力、眼压、眼内炎性反应、晶体、眼底改变，光学相干断层扫描（optic coherent tomography，OCT）测定黄斑区视网膜厚度变化。结果30只眼中，有22只眼（73％）视力提高，3只眼（10％）视力不变。2只眼（7％）继发性青光眼，2只眼（7％）并发性白内障，1只眼（3％）视网膜脱离。LogMAR视力治疗前为0．78±0．50，治疗后1周、1个月、3个月时分别为0．62±0．48，0．45±0．37，0．31±0．28。黄斑中心凹平均厚度治疗前为（589±132）μm，治疗后1周、1个月、3个月时分别为：（341±122）μm；（201±61）μm；（162±41）μm。治疗前后比较差异有统计学意义（P〈0．01）。30只眼中有5只眼（17％）治疗后暂时性眼压轻度升高，经局部药物短期治疗后恢复正常；2只眼（7％）继发性青光眼，给与小梁切除术治疗；2只眼（7％）并发性白内障；1只眼（3％）视网膜脱离，给与激光光凝治疗。结论IVTA可以在短期内有效地治疗CRVO继发的黄斑水肿，但其并发症不容忽视。Objective To evaluate the efficacy and complication of Intmvitreal triamcinolone acetonide （IVTA） in the treatment of macular edema associated with central retinal vein occlusion （CRVO）. Methods Thirty eyes of 30 patients with severe macular edema due to CRVO underwent IVTA with 4mg/0.1ml.Best-corrected visual acuity, intraocular pressure （IOP）, inflammatory extent, manifestation of lens and fundus were observed before trea^nent and one day, three days, one week, one month, three months after treatment. The retinal thickness was examined by optic coherent tomography （OCT）. Results Of all 30 eyes 22 eyes （73%） had improved visual acuity, 3 eyes （10%） remained the same. 2 eyes（7%） had secondary glaucoma, 2 eyes （7%） had supervented cataract and 1 eye （3%） had retinal detachment.The LogMAR visual acuity was 0.78±0.50 before treatment, while 1 week, 1 month and 3 months after IVTA, the average visual acuity was 0.62± 0.48, 0.45± 0.37 and 0.31±0.28 respectively. The average retinal thickness at macular area was 589± 1 32urn before treatment, while 1 week, 1 month and 3 months after IVTA, the average retinal thickness was （341 ±122） μm; （201 ±61 ） μ m; （ 162± 41 ） μm respectively, which had statistical significance compared with that before treatment （P〈0.01）. 5 eyes（17%） of all 30 eyes had high intraocular pressure （IOP）, temporarily, and IOP was controlled after treated with topical eye drop.2 eyes （7%） had secondary glaucoma, with the treatment of trabeculectomy. 2 eyes（7% ） had supervented cataract. 1 eye（ 3% ） had retinal detachment, with the treatment of laser photocoagulation. Conclusions IVTA is effective for macular edema secondary to CRVO in a short time, while the complication can not be ignored.

关 键 词：视网膜静脉阻塞 曲安奈德治疗应用 黄斑水肿药物疗法 并发症 

分 类 号：R779.1[医药卫生—眼科] R774.1[医药卫生—临床医学]