DR患者玻璃体切割术后黄斑水肿的治疗  

Clinical observation of the treatment of macular edema after vitrectomy in patients with proliferative diabetic retinopathy

作　　者：王丁丁[1] 宋青山[1] 周慧兰[1] 陈子林[1] 

机构地区：[1]中国广东省惠州市中心人民医院眼科,516001

出　　处：《国际眼科杂志》2012年第9期1716-1718,共3页International Eye Science

摘　　要：目的:观察增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)玻璃体切割术后球周注射曲安奈德(triamcinolone acetonide,TA)联合黄斑区补充光凝治疗黄斑水肿的临床疗效。方法:PDR患者43例行玻璃体切割术及眼内全视网膜光凝术毕球周注射TA40mg/mL,术后1wk选择有黄斑水肿患者32例,术后2wk行黄斑区补充532nm激光,术后1wk;1,3,6mo随访最佳矫正视力(best-corrected visual acuity,BCVA)、黄斑中心凹视网膜厚度(central macular thickness,CMT)、并发症。结果:术后1mo视力提高28例(88%),视力不变4例(12%),与术后1wk比较差异有显著性(P<0.05);术后3,6mo检查BCVA变化不大,与术后1mo比较均无显著性差异(P>0.05);术后1wkCMT明显增厚,术后1mo黄斑水肿均不同程度减轻,与术后1wk比较差异有显著性(P<0.05),术后3,6moCMT变化不大,与术后1mo比较均无显著性差异(P>0.05)。所有患者术后反应较轻,未出现严重并发症。结论:术后球周注射TA与黄斑区补充光凝结合起来治疗PDR患者术后糖尿病黄斑水肿取得了满意持久的临床效果。AIM：To study the efficacy of retrobulbar injection of triamcinolone acetonide（TA） combined with macular laser photocoagulation after vitrectomy in patients with proliferative diabetic retinopathy（PDR） for the treatment of diabetic macular edema.METHODS：PPV combined with full panretinal photocoagulation were performed in 43 cases with PDR, 40mg/mL TA after operation were injected retrobulbarly, 32 cases with macular edema diagnosed 1 week later were treated with macular laser photocoagulation（532nm） 2 weeks postoperatively. The best-corrected visual acuity（BCVA）, CMT and complications were analyzed after postoperative 1 week, 1 month, 3 and 6 months.RESULTS：Twenty-eight cases＇ BCVA（88%） increased after 1 month, 4 cases（12%） were not changed. The difference of BCVA after 1 month compared with after 1 week was statistically significant（P0.05）, the difference of BCVA after 3 and 6 months compared with after 1 month was not statistically significant（P0.05）. The CMT was thickening after 1 week, and decreased after 1 month compared with after 1 week, the difference was statistically significant（P0.05）. The difference of CMT after 3 and 6 months compared with after 1 month was not statistically significant（P0.05）. The serious, irreversible complications had not been found in all patients during follow-up.CONCLUSION：Retrobulbar injection of TA combined with macular laser photocoagulation for the treatment of PDR, postoperative DEM gained satisfactory and long lasting clinical effect.

关 键 词：光凝 曲安奈德 球周注射 糖尿病黄斑水肿 增生性糖尿病视网膜病变 

分 类 号：R779.6[医药卫生—眼科]