频域OCT在玻璃体腔注射曲安奈德治疗糖尿病性视网膜病变继发黄斑水肿中的临床应用  

Clinical Application of IVTA Treatment for ME in DR By Spectra Domain OCT

作　　者：罗立勤[1] 郑利民[1] 杜鹏程[1] 霍建新[1] 杨建华[1] 张琳[1] 王俊琴[1] 

机构地区：[1]包头医学院第一附属医院眼科,内蒙古包头014010

出　　处：《中国伤残医学》2012年第7期17-19,共3页Chinese Journal of Trauma and Disability Medicine

基　　金：内蒙古自治区高等学校科学研究项目项目编号:NJZY11185;包头市科技计划项目项目编号:2011S2012-01-11

摘　　要：目的:通过频域OCT观察玻璃体腔注射曲安奈德(TA)治疗糖尿病视网膜病变(DR)继发黄斑水肿(ME)的临床效果。方法:回顾性分析36例我院眼科常规检查及经FFA和频域OCT检查均确诊为DR继发ME患者36例,视力≤0.6,黄斑中心凹厚度(CMT)≥250μm的患者36只眼纳入观察,进行玻璃体腔注射TA(4mg,0.1ml)治疗。比较治疗前和治疗后1天及1,2,4,8,12,24周最佳矫正视力(BCVA)改变;治疗前和治疗后1,2,4,8,12,24周的黄斑中心凹厚度(CMT)、黄斑中心容积(CMV)、黄斑区平均厚度(AVG)的改变。结果:在治疗后视力显著提高,术后各时间点(P=0.000)均具有统计学意义,BCVA各点分别为:4周0.3962±0.1326;8周0.4936±0.1853;12周0.5164±0.1649,视力基本持平,24周0.3274±0.1812,缓慢下降,术后1周有21例视力提高大于3行,占55.26%。CMT方面,较基线比,在治疗后CMT明显降低,术后各时间点(P=0.000)均具有统计学意义。与基线相比,CMV、AVG两具有显著改变。BCVA分别与CMT、CMV、AVG呈负相关。治疗后眼压未见明显升高。结论:玻璃体腔注射TA治疗糖尿病视网膜病变继发黄斑水肿可明显改善,减轻黄斑水肿。BCVA分别与CMT、CMV、AVG呈负相关,CMV、AVG也可反映治疗效果,但敏感性不及CMT。Objective：To observe the efficiency of IVTA for the treatment of ME in DR by spectra domain OCT.Methods：A total of 38 eyes with ME second to DR were observed.All patients were diagnosed expecially by FFA and spectra domain OCT,with vision≤0.6 and CMT≥250 μ m.All received intravitreal injection of 4mg/0.1ml of TA.BCVA、CMT,CMV,and AVG were compared before and after treatment.Results：After treatment,BCVA were significantly increased in each time point（P=0.000）,BCVA in 4（BCVA=0.3962 ± 0.1326）,8（BCVA=0.4936 ± 0.1853）,12（BCVA=0.5164 ± 0.1649） weeks,were similar.After treatment,compared with baseline,the changes of CMT、CMV and AVG were significantly increased in each time point（P=0.000）.Conclusions：IVTA for the treatment of ME in ME could increase BCVA and reduce ME instinctively.CMT can reveal the effect of treatment better than CMV and AVG.

关 键 词：频域OCT 曲安奈德 糖尿病性视网膜病变 黄斑水肿 

分 类 号：R77[医药卫生—眼科]