单独玻璃体腔曲安奈德注射与合并黄斑格栅样光凝治疗糖尿病黄斑水肿的对照研究  

The study grid laser photocoagulation after intravitreal triamcinolone and only intravitreal triamcinolone for the treatment of diffuse diabetic macular edema

作　　者：胡磊[1] 马伟健[1] 陈迪[1] 李艳春[1] 

机构地区：[1]泰山医学院附属医院眼科,山东省泰安271000

出　　处：《临床眼科杂志》2009年第6期495-497,共3页Journal of Clinical Ophthalmology

摘　　要：目的观察玻璃体腔曲安奈德注射(IVTA)与IVTA后合并黄斑格栅样光凝作为对照治疗糖尿病黄斑水肿(DME)的临床效果。方法74例(86只眼)有DME的糖尿病患者被随机分为2组,激光治疗组(n=48)在IVTA后3周行黄斑部格栅样光凝,对照组(n=38)仅行IVTA。所有患者治疗前后均行眼底、视力、荧光素眼底血管造影(FFA)、光相干断层扫描(OCT)和视网膜中央厚度检查,用Spss10统计分析两组治疗后3周、3个月和6个月的视力及中央部黄斑区厚度。结果IVTA组在治疗初、3周、3个月、6个月平均黄斑中央厚度为510μm、227μm、302μm和437μm;而激光组则是538μm、250μm、295μm和301μm。两组在3周和3个月时比较有统计学意义,其后IVTA组黄斑区视网膜厚度增加,黄斑水肿复发。两组视力在治疗开始和3周后没有明显差别,而在3个月和6个月时的视力激光治疗组差别具有统计学意义(分别是P=0.02和P<0.001)。结论IVTA后黄斑格栅样光凝有效的改善了DME引起的视力损害,同时还减少了DME复发。Objective To evaluate the clinical outcomes of macular laser photocoagulation after the intravitreal injection of 4 mg of triamcinolone acetonide （IVTA） as compared to intravitreal injection only IVTA for diffuse diabetic macular edema （DME）.Method Eighty-six eyes of 74 patients with diffuse DME were randomized into 2 groups. The laser group eyes （n=48） were subjected to a macular grid laser photocoagulation 3 weeks after IVTA. The control group eyes （n=38） underwent only IVTA. Both groups were compared with regard to the changes in visual acuity and central macular thickness at 3 weeks,3 months,and 6 months after IVTA.Results The mean central macular thickness before,3 weeks after,and 3 and 6 months after IVTA were 538,250,295,and 301 ？m in the laser group vs 510,227,302,and 437 μm in the control group,respectively. The visual acuities were not significantly different between the 2 groups at baseline and at 3 weeks after IVTA but were significantly better in the laser group at 3 （P=0.02） and 6 months （P0.001） after IVTA.Conclusion Macular laser coagulation effectively maintains improved visual acuity after IVTA for diffuse DME and is believed to reduce recurrent DME after IVTA.

关 键 词：玻璃体腔曲安奈德注射 糖尿病黄斑水肿 黄斑区格栅样光凝 

分 类 号：R587.1[医药卫生—内分泌] R774.5[医药卫生—内科学]