后Tenon囊下注射曲安奈德治疗缺血型视网膜静脉阻塞黄斑水肿短期疗效观察  

Short-term efficacy of posterior sub-tenon injection of triamcinoione acetonide in macular edema due to ischemic retinal vein occlusions

作　　者：褚梦琪 毛剑波[1] 朱莎[1] 陈亦棋[1] 吴素兰[1] 张赟[1] 陶继伟[1] 赵士鑫[1] 沈丽君[1] 

机构地区：[1]温州医科大学附属眼视光医院杭州院区,310020

出　　处：《中华眼底病杂志》2016年第5期522-526,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：国家科技重大专项（2014ZX09303301）;十二五国家科技支撑计划项目（2012BA108802）;浙江省医药卫生平台项目（2016RCB012）;浙江省科技厅重大科技专项重大社会发展项目（2013C03048-3）;温州科技计划项目（Y20140173）

摘　　要：目的观察后Tenon囊下注射曲安奈德（PSTA）治疗缺血型视网膜静脉阻塞（RVO）黄斑水肿的短期临床疗效。方法回顾性非随机对照临床研究。通过眼底彩色照相、荧光素眼底血管造影及光相干断层扫描（OCT）检查确诊的RVO黄斑水肿患者53例53只眼纳入研究。所有息眼均采用国际标准视力表检测最佳矫正视力（BCVA），并将结果转换为最小分辨角对数（10gMAR）视力记录。利用OCT自带软件测量患眼黄斑中心凹厚度（CMT）。53只眼中，缺血型RVO黄斑水肿（缺血型组）27只眼，平均logMARBCVA为0．82±0．37，平均CMT为（662．1±216．7）μm；非缺血型RV0黄斑水肿（非缺血型组）26只眼，平均logMARBCVA为0．41±0．23，平均CMT为（548．0±161．9）μm。两组患眼logMARBCVA、CMT比较，差异有统计学意义（t=4．745、2．258，P〈0．05）。所有患眼均行单次PSTA治疗，注射曲安奈德悬浮液0．4ml（含曲安奈德40mg）。对比观察两组患眼治疗后1、3个月logMARBCVA、CMT与治疗前IogMARBCVA、CMT的异同以及药物、眼部注射相关并发症的发生情况。结果治疗后1、3个月，缺血型组患眼平均logMARBCVA分别为0．76±0．37、0．79±0．41；非缺血型组患眼平均logMARBCVA分别为0．32±0．25、0．27±0．29。非缺血型组患眼平均logMARBCVA较缺血型组患眼明显提高，差异有统计学意义（t=5．052、5．240，P〈0．05）。缺血型组患眼治疗前后平均logMARBCVA比较，差异无统计学意义（F=0．516，P〉0．05）；非缺血型组患眼治疗前后平均logMARBCVA比较，差异有统计学意义（F=7．685，P〈0．05）。治疗后1、3个月，缺血型组患眼平均CMT分别为（534．7±223．4）、（470．8±234．7）μm，较治疗前分别降低（127．4±28．3）、（191．4±34．6）μm。非缺血型组患眼平均CMT分别为（426．2±188．8）、（371．3±200．6）μm，较治疗前分别降低（103．1±33．Objective To observe the short-term efficacy of posterior sub-tenon injection of triamcinolone acetonide （PSTA） in the treatment of macular edema due to ischemic retinal vein occlusions （RVO）. Methods A retrospective clinical study. A total of 53 eyes of 53 patients with RVO macular edema diagnosed by fundus color photography, fundus fluorescein angiography and optical coherence tomography （OCT） were included in the study. The best corrected visual acuity （BCVA） was detected by the international standard visual acuity chart, and the results were converted to the logarithm of the minimum angle of resolution （logMAR） visual acuity. The central macular thickness （CMT） was measured by OCT. Among 53 eyes, there were 27 eyes with ischemic RVO macular edema （ischemic group） and 26 eyes with non-ischemic RVO macular edema （non-ischemic group）. The mean logMAR BCVA was 0. 82 ± 0.37, mean CMT was （662. 1±216.7） μm in ischemic group. The mean IogMAR BCVA was 0. 41±0.23, mean CMT was （548.0±161.9） μm. The differences of logMAR BCVA and CMT between the two groups were both statistically significant （t = 4. 745, 2. 258; P〈 0. 05）. All eyes were treated with a single sub-Tenon injection of 0.4 ml triamcinolone aeetonide suspension （100 mg/ml）. The mean logMAR BCVA, CMT before and 1, 3 months after the treatment between the two groups were observed and compared. Results On 1 and 3 months after treatment, the mean logMAR BCVA in the non-isehemic group （0.32±0.25 and 0. 27±0. 29） were improved compared with ischemic group （0.76±0.37 and 0.41±0.79）, the difference was statistically significant （t = 5. 052, 5. 240; P〈 0.05）. The mean logMAR BCVA before and after treatment had no statistically significant difference in ischemic group （F= 0. 516, P〉0.05）, but had a statistically significant difference in non-ischemic group （F= 7. 685, P〈0.05）. On 1 and 3 months after treatment, the mean CMT in the isehemic group were （534.7±223.4）, （470.8±234

关 键 词：视网膜静脉闭塞/药物疗法 黄斑水肿/药物疗法 曲安奈德/治疗应用 

分 类 号：R774[医药卫生—眼科]