曲安奈德玻璃体腔注射联合激光光凝治疗糖尿病性视网膜病变继发黄斑水肿的临床分析  

Intravitreal Triamcinolone Acetonide and Laser Photocoagulation for Diabetic Macular Edema

作　　者：杨建华[1] 张琳[1] 郑利民[1] 罗立勤[1] 杜鹏程[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10期21-23,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:评价玻璃体腔注射曲安奈德(IVTA)联合视网膜光凝对糖尿病视网膜病变(DR)继发黄斑水肿(ME)的治疗效果。方法:回顾性分析30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30例,视力≤0.6,黄斑中心凹厚度(CMT)≥250μm的患者30只眼纳入观察,将DME患者30例(30眼)随机分为单纯光凝组、联合治疗组(光凝联合曲安奈德玻璃体腔注射组),每组15眼。联合治疗组在格栅样光凝前1周进行玻璃体腔注射TA(4mg,0.1ml)治疗。观察2组治疗前后最佳矫正视力(BCVA)和黄斑中心凹厚度(CMT)的改变。结果:联合组治疗后BCVA提高和CMT显著改善。光凝组和联合治疗组BCVA在术后12周为0.23±0.14和0.36±0.12,术后24周为0.25±0.13和0.38±0.16;CMT在术后12周为318.4±135.2μm和270.2±114.7μm,术后24周为308.8±116.5μm和245±107.9μm;2组间差异有统计学意义(P<0.05和P<0.01)。BCVA与CMT呈负相关。治疗后眼压未见明显升高。结论:玻璃体腔注射TA联合激光光凝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与CMT呈负相关,CMT可反映治疗效果。Objective： To evaluate the efficiency of IVTA combined with laser photocoagulation for DME. Methods： Thirty eyes of 30 patients with ME diagnosed expecially by FFA and spectra domain OCT, with vision ≤0.6 and CMT≥250 um, were randomly divided into two groups： the simple laser photocoagulation group （n=15） and the laser combination with IVTA-photocoagulaion group （n =15）. Eyes in the combination group were subjected to laser photocoagulation one week after 4 mg IVTA. The BCVA, CMT （by spectra domain OCT） and post operative complications were compared between the two groups. Results：After treatment,BCVA was improved and CMT was reduced in the two groups. BCVA was 0.23 ± 0.14 and 0.36 ±0.12 at 12 weeks and 0.25 ± 0.13 and 0.38 ± 0.16 at 24 weeks, CMT was 318.4 ±135.2 um and 270.2 ± 114.7 u m at 12 weeks and 308.8 ± 116.5 um and 245 ± 107.9 u m at 24 weeks, for the laser photocoagulation group and combined group, respectively （P〈0.001）.Conclusions： IVTA combined with laser photocoagulation is superior to simple laser photocoagnlation in improving BCVA and reducing CMT. CMT can reveal the effect of treatment.

关 键 词：糖尿病视网膜病变 黄斑水肿 曲安奈德 激光光凝 频域OCT 

分 类 号：R776.05[医药卫生—眼科]