后Tenon囊下注射曲安奈德治疗弥漫性糖尿病性黄斑水肿的临床观察  

Clinical observation of posterior Tenon subtenon triamcinolone acetonide for diffuse diabetic macular edema

作　　者：王健[1] 解正高[1] 陈放[1] 庄朝荣[1] 

机构地区：[1]江苏省苏北人民医院扬州大学临床医学院眼科,225001

出　　处：《中国医师进修杂志》2013年第21期12-15,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨后Tenon囊下注射曲安奈德（TA）治疗弥漫性糖尿病性黄斑水肿的疗效与安全性.方法 对通过眼底荧光血管造影及光学相干断层扫描确诊的弥漫性糖尿病性黄斑水肿42例（54眼）患者行后Tenon囊下注射TA 20 mg,分别于术前和术后不同时间检查视力、眼压、黄斑中心凹视网膜厚度.结果 术前视力为0.26±0.15,术后2周、1个月、2个月、3个月、6个月分别为0.29±0.13、0.34±0.14、0.43±0.16、0.41±0.13、0.38±0.17,术后视力明显改善,术后2周与术前比较差异无统计学意义（P＞0.05）,其余各时间点与术前比较差异均有统计学意义（P＜0.01）.术前黄斑中心凹视网膜厚度为（473.9±121.8） μm,术后2周、1个月、2个月、3个月、6个月分别为（462.6±93.3）、（342.8±87.1）、（302.6±67.8）、（321.1±79.1）、（355.2±47.6）μm,术后2周与术前比较差异无统计学意义（P＞0.05）,其余各时间点与术前比较均显著下降,差异有统计学意义（P＜0.01）.术后2个月时眼压升高,与术前比较差异有统计学意义（P＜0.05）,除眼压升高外所有患者无其他并发症.结论 后Tenon囊注射TA是一种治疗弥漫性糖尿病性黄斑水肿安全、有效的方法,可以重复注射.Objective To study the effect and safety of posterior Tenon subtenon triamcinolone acetonide （TA） injection as treatment for diffuse diabetic macular edema.Methods Forty-two patients （54 eyes） with diffuse diabetic macular edema were diagnosed by fundus fluorescence angiography and optical coherence tomography,posterior Tenon subtenon injection of TA 20 mg for treatment.All eyes were examined before treatment and the different time points after treatment by testing visual acuity,intraocular pressure,thickness of macular fovea.Results Preoperative visual acuity was 0.26 ± 0.15,postoperative was 0.29 ± 0.13,0.34 ± 0.14,0.43 ± 0.16,0.41 ± 0.13,0.38 ± 0.17 at 2 weeks,1 month,2 months,3 months and 6 months,respectively,visual acuity improved significantly,there was no significant difference between 2 weeks postoperative and preoperative （P 〉 0.05）,the remaining time points compared with preoperative differences were statistically significant （P 〈 0.01）.Preoperative thickness of macular fovea was （473.9 ±121.8） μ m,postoperative was （462.6 ± 93.3） μ m,（342.8 ± 87.1） μ m,（302.6 ± 67.8） μ m,（321.1 ±79.1） μ m,（355.2 ± 47.6） μ m at 2 weeks,1 month,2 months,3 months and 6 months,respectively,there was no significant difference between 2 weeks postoperative and preoperative （P 〉 0.05）,the remaining time points compared with preoperative differences were statistically significant （P 〈 0.01）.The intraocular pressure at 2 months were significantly higher than preoperative （P 〈 0.05）.No other complications were observed.Conclusion Posterior Tenon subtenon injection of TA as treatment for diffuse diabetic macular edema is safe and effective,which can inject repeatly.

关 键 词：黄斑水肿 曲安奈德 后Tenon囊 

分 类 号：R774.5[医药卫生—眼科] R587.2[医药卫生—临床医学]