玻璃体腔注射曲安奈德联合黄斑格栅光凝治疗黄斑囊样水肿  

Clinical observation of both intravitreal injection of triamcinolone acetonide and macular laser grid photocoagulation for the treatment of cystoid macular edema

作　　者：王玉萍[1] 张文芳[1] 王蓓[1] 

机构地区：[1]兰州大学第二医院眼科,甘肃兰州730030

出　　处：《兰州大学学报（医学版）》2008年第2期57-59,62,共4页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的观察玻璃体腔注射曲安奈德联合黄斑格栅光凝治疗黄斑囊样水肿的近期疗效及安全性。方法选取糖尿病和视网膜静脉阻塞所致的黄斑水肿患者37例37眼,将观察对象分为两组,联合治疗组17例17眼,玻璃体腔注射曲安奈德0.1 mL(40 mg/mL),3周后联合黄斑格栅光凝治疗;单纯注射组20例20眼,单纯行玻璃体腔注射曲安奈德0.1 mL(40 mg/mL)。治疗后在3、6和10个月进行复查,对比分析两组治疗前后视力、眼压、眼底、荧光素眼底血管造影的改变。结果所有患者注射后1月视力多数有明显提高。治疗后10个月末次随访时,联合治疗组视力提高≥2行者11只眼(64.7%),视力稳定及变化在1行之内者4只眼(23.5%),视力下降≥2行者2只眼(11.8%);单纯曲安奈德注射组视力提高≥2行者3只眼(15.0%),视力稳定及变化在1行之内者11只眼(55.0%),视力下降≥2行者6只眼(30.0%),与单纯注射组比较,二者的差异有统计学意义(P<0.05)。荧光素眼底血管造影检查黄斑水肿吸收或明显缓解。结论玻璃体腔注射曲安奈德联合黄斑格栅光凝能有效治疗黄斑囊样水肿,延缓视力下降,并可减少重复治疗的次数。Objective To evaluate the efficacy and security of both intravitreous injection with triamcinolone acetonide and macular laser grid photocoagulation for the treatment of cystoid macular edema. Methods 37 patients（37 eyes） with cystoid macular edema caused by diabetes or retinal venous occlusion were divided into two groups, 17 patients（17 eyes） were intravitreously injected with 0.1 mL triamcinolone acetonide（40 mg/mL）, after 3 weeks, macular laser grid photocoagulation was performed on each patient. 20 patients（20 eyes） were intravitreously injected with 0.1 mL triamcinolone acetonide（40 mg/mL） only. The visual acuity, intraocular pressure, fundus and fundus fluorescein angiography（FFA） were observed and compared before 3, 6 and 10 months after the treatment. Results All eyes except two had improved visual acuity. At the end of the follow-up period（10 months）, patients both intravitreous injection with triamcinolone acetonide（TA） and macular laser grid photocoagulation the visual acuity increased≥2 lines in 11（64.7%）, changed within 1 line in 4（23.5%）, and decreased≥2 lines in 2（11.8%）; patients were intravitreously injected with TA only, the visual acuity increased≥2 lines in 3（15.0%）, changed within 1 line in 11（55.0%）, and decreased≥2 lines in 6（30.0%）, the difference was statistically significant（P 〈0.05）. The result of FFA showed less leakage of fluorescein. Conclusion Macular laser grid photocoagulation combined with intravitreal injection with TA for cystoid macular edema is safe and effeeitive. It may reduce the risk of visual loss and reduce the treatment frequency.

关 键 词：黄斑水肿 曲安奈德 光凝 

分 类 号：R774.5[医药卫生—眼科]