激光与曲安奈德治疗糖尿病性黄斑水肿的疗效比较  

Comparison Between Efficacy of Triamcinolone Acetonide and Laser Treatment for Diabetic Macular Edema

作　　者：刘鸿飞[1] 刘静[1] 张冬梅[1] 

机构地区：[1]河南焦作煤业集团中心医院眼科,焦作市454000

出　　处：《中国激光医学杂志》2009年第6期365-368,共4页Chinese Journal of Laser Medicine & Surgery

摘　　要：目的对比激光与曲安奈德治疗黄斑水肿的疗效和安全性。方法回顾性地分析46例50只眼具有完整资料的糖尿病黄斑水肿患者。其中23只眼行黄斑区局部或格栅样激光光凝(激光组);27只眼行玻璃体腔注射曲安奈德0.1 ml(4 mg)(曲安奈德组)。随访24个月以上,观察视力、眼压、晶状体及眼底改变、荧光素眼底血管造影(FFA)和OCT,比较两种疗法的疗效。结果激光组与曲安奈德组术后黄斑水肿消退分别为20只眼(87.0%)和15只眼(55.6%);眼压升高10 mmHg以上分别为1只眼(4.3%)和9只眼(33.3%);术后行白内障手术分别为3只眼(13.0%)和13只眼(48.1%);差异均有显著意义(P<0.05)。结论激光比曲安奈德治疗糖尿病黄斑水肿更安全有效,不良反应更少。Objective To compare the efficacy and safety of the triamcinolone acetonide（TA） and the laser treatment for diabetic macular edema（DME）. Methods A retrospective comparative study of 46 patients（50 eyes） with diabetic macular edema with full clinical data was conducted,there were 27 eyes by intravitreous injection with 0.1 ml（4 mg） TA,and another 23 eyes by focal or grid photocoagulation to diabetic macular edema.The patients were all followed up over 24 months.The visual acuity,intraocular pressure,and lens status were evaluated,and the macular morphologic changes were detected by optical coherence tomography（OCT）or fundus fluorescein angiography（FFA）. Results Over 24 months period,the mean visual acuity was better in the laser group than in the TA group（P〈0.05）.The intraocular pressure was increased from baseline by 10 mmHg or more at any visit in 4.3%（1 eye） and 33.3%（9 eyes） of eyes in the 2 treatment groups,respectively,and the cataract surgery was performed in 13.0%（3 eyes） and 48.1%（13 eyes） of eyes in the 2 treatment groups,respectively（P〈0.05）. Conclusions Focal or grid photocoagulation is more effective and has fewer side effects than 0.1 ml（4 mg）doses of intravitreal TA for the most patients with DME.

关 键 词：糖尿病黄斑水肿 曲安奈德 激光 

分 类 号：R779.64[医药卫生—眼科]