后Tenon囊下注射曲安奈德治疗黄斑水肿对眼压的影响  

Changes of intraocular pressure after posterior sub-Tenon's capsule injection with triamcinolone acetonide for macular edema

作　　者：王良雨[1] 周占宇[1] 赵善瑶 王云霄[1] 

机构地区：[1]青岛大学医学院附属医院眼科,中国山东省青岛市266003

出　　处：《国际眼科杂志》2012年第3期492-494,共3页International Eye Science

摘　　要：目的:研究后Tenon囊下注射20mg曲安奈德(TA)治疗黄斑水肿后的眼压变化及眼压升高的影响因素。方法:黄斑水肿患者46例46眼,病因为糖尿病性视网膜病变16例,年龄相关性黄斑变性13例,视网膜静脉栓塞11例,后葡萄膜炎6例,均行后Tenon囊下注射20mgTA。注射前测量眼压,并于注射后2wk;1,2,3,4,5,6mo随访观察眼压变化。结果:患者46例术后2wk;1,2,3,4,5,6mo平均眼压较术前均有升高。术后3mo时,平均眼压达最高值(19.22±6.86)mmHg,有17例(37%)患者IOP>21mmHg。术后2wk;1,2,3,4,5mo眼压与术前比较,差别有统计学意义(值分别为3.747,5.836,5.982,5.866,4.202,3.246,均P<0.05),术后6mo眼压与术前比较,差别无统计学意义(t=1.446,P>0.05)。年轻、基础眼压高是后Tenon囊下注射曲安奈德后继发性眼压升高的危险因素(χ2值分别为5.599,10.323,均P<0.05),而性别、病因与后Tenon囊下注射曲安奈德后继发性眼压升高没有相关性(χ2值分别为0.022,0.050,均P>0.05)。结论:后Tenon囊下注射20mg曲安奈德,引起眼压升高较为常见,在注射后3mo时眼压升高最为明显,注射后6mo时回落至基础眼压水平。年轻、基础眼压高是继发性眼压升高的危险因素。注射后进行最短为期6mo的眼压随访是非常必要的,尤其是对于年轻患者及基础眼压高的患者。AIM：To investigate the changes of intraocular pressure （IOP） and associated factors of IOP elevation after posterior sub-Tenon＇s capsule （PST） injection with triamcinolone acetonide （TA） for macular edema. METHODS：The study included 46 cases（46 eyes） who received PST injections of 20mg TA to treat macular edema with diabetic retinopathy （n=16）,age-related macular degeneration （n=13）, retinal vein occlusion （n=11）,and posterior uveitis （n=6）. IOP measurements were performed on the day of injection, and 2 weeks,1 month,2, 3, 4, 5 and 6 months later. RESULTS：The mean IOP of all eyes showed a gradual increase after the injection, peaked at 3 months （19.22±6.86mmHg）, and then decreased gradually until reaching a minimum at 6 months. Of the 46 eyes, 17（37%） showed an IOP above 21 mmHg at 3 months post-injection. Compared with the pre-injection, the mean IOP increased significantly at 2 weeks,1 month,2,3,4,5 months（t value were 3.747, 5.836, 5.982, 5.866, 4.202, 3.246 respectively, all P0.05）, however, there was no significant difference between the pre-injection and the 6 months post-injection （t=1.446,P0.05） . And IOP elevation significantly correlated with younger age（χ2=5.599,P0.05）and higher baseline IOP（χ2=10.323,P0.05）, but not with gender（χ2=0.022,P0.05）or disease（χ2=0.050,P0.05）. CONCLUSION：E1evation of IOP after PST injection with TA is not rare and the peak level usually occurs at 3 months post-injection, and then the IOP decreases gradually to approach the baseline level until 6 months post-injection. Younger age and higher baseline IOP are identified as risk factors. Our findings indicate that careful assessment of IOP during a follow-up at least 6 months is necessary,especially in those who are younger or with higher baseline IOP.

关 键 词：后TENON囊下注射 曲安奈德 眼内压 

分 类 号：R774.5[医药卫生—眼科]