后Tenon囊下注射曲安奈德治疗全视网膜光凝术后持续性黄斑水肿  

The effect of posterior sub-tenon capsule injection of triamcinolone acetonide on macular edema that persists after panretinal photocoagulation for treatment of diabetic retinopathy

作　　者：张世杰[1] 杨柳[1] 李骏[1] 

机构地区：[1]北京大学第一医院,视觉损伤与修复教育部重点实验室,北京100034

出　　处：《中国实用眼科杂志》2012年第11期1345-1347,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察曲安奈得后Tenon囊下注射对糖尿病性视网膜病变全视网膜光凝术引起的持续性黄斑水肿的疗效。方法2007年1月至2011年12月因糖尿病性视网膜病变进行标准全视网膜光凝（PRP）治疗的患者。激光治疗前进行最佳矫正视力、眼压、散瞳眼底、眼底荧光血管造影和OCT等检查。PRP术后1个月复查，最佳矫正视力较PRP前下降2行以上，同时OCT检查出现明显黄斑水肿的患者进行曲安奈得40mg后Tenon囊下注射。注射后1周、1个月复查最佳矫正视力、眼压、散瞳眼底检查和OCT。结果共有7例11只眼行全视网膜光凝术后出现视功能下降超过2行，OCT显示出现明显黄斑水肿。曲安奈得治疗后一周所有患者视功能均有提高，OCT显示黄斑水肿均减轻。一个月时眼视功能恢复至激光治疗前水平，OCT显示黄斑基本恢复激光治疗前，黄斑水肿完全消退。所有随访时间未见有眼压升高患者。结论后Tenon囊下注射曲安奈得是治疗糖尿病性视网膜病变全视网膜光凝术后持续性黄斑水肿的简单有效治疗方法。Objective To observe the effect of posterior sub-tenon capsule injection of triamcinolone aeetonide （TA） on persistent macular edema after panretinal photocoagulation for treatment of diabetic retinopathy. Methods From January 2007 to December 2011, for the patients who accepted panretinal photocoagulation （PRP） therapy due to diabetic retinopathy in our hospital, best-corrected visual acuities （BCVAs）, intraocular pressure （IOP）, fundus examination, fundus fluorescein angiography （FFA）, and central retinal thickness （CRT） on OCT scan were collected before PRP. One month after PRP, 40mg TA were injected into posterior sub-tenon capsule for those patients whose BCVAs declined over 2 lines and CRT increased over 200μm. One week and one month after TA injection, BCVAs, IOP, fundus examination, CRT on OCT scan were collected. Results BCVAs declined over 2 lines and CRT increased over 200μm was foundin 11 eyes of 7 patients. One week after TA injection, BCVAs were improved and macular edema decreased in all patients. One month after TA injection, BCVAs and CRT were recovered completely. There was no elevation of IOP founded in follow-up period. Conclusions Injection of triamcinolone acetonide into the posterior sub-tenon capsule is a simple and effective treatment of macular edema that persists after panretinal photocoagulation.

关 键 词：糖尿病性视网膜病变 全视网膜光凝术 黄斑水肿 曲安奈德 后Tenon’s囊下注射 

分 类 号：R[医药卫生]