曲安奈德球周注射联合阈下值微脉冲激光对糖尿病性黄斑水肿的疗效观察  被引量:3

Study on the combination treatment of peribulbar injection of triamcinolone acetonide and subthreshold micropulse laser for diabetic macular edema

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作  者:唐孟苏 张淑琦[2] 马立威[1] TANG Mengsu;ZHANG Shuqi;MA Liwei(Department of Ophthalmology,the Fourth Hospital Affiliated of China Medical University,Shenyang 110004,China;Department of Ophthalmology,the 463 Hospital of the Chinese People’s Liberation Army,Shenyang 110042,China)

机构地区:[1]中国医科大学附属第四医院眼科,沈阳110004 [2]中国人民解放军第463医院眼科,沈阳110042

出  处:《中国实用眼科杂志》2018年第5期364-367,共4页Chinese Journal of Practical Ophthalmology

摘  要:目的探讨曲安奈德球周注射联合阈下值微脉冲激光治疗糖尿病黄斑水肿的临床疗效。方法重度非增殖性糖尿病性视网膜病变患者60例(60只眼),随机分为两组,一组接受曲安奈德球周注射联合微脉冲激光治疗(联合组,30只眼),另一组接受微脉冲激光治疗(对照组,30只眼),联合组微脉冲激光治疗结束后进行曲安奈德20 mg球周注射,以后每隔4周注射一次,共3次。两组患者在微脉冲激光治疗1周后接受全视网膜光凝。观察记录治疗前后黄斑中心视网膜厚度、视网膜光敏感度及最佳矫正视力(BCVA)的变化。结果两组患者治疗后黄斑中心视网膜厚度都显著降低(F=74.082,P<0.05),联合组降低更为明显(F=4.033,P<0.05)。两组治疗后黄斑区光敏感度和BCVA都显著提高(均P<0.05);与自身相比联合组治疗后1个月时提高显著(均P<0.05),对照组在治疗后3、6个月时也分别显著提高(均P<0.05)。结论阈下值微脉冲激光可以减轻黄斑水肿,改善黄斑区视网膜敏感度,提高视力,联合曲安奈德球周注射可以加快恢复速度。Objective To investigate the efficacy of subthreshold micropulse laser combined with peribulbar injection of triamcinolone acetonide in the treatment for diabetic macular edema.Methods Sixty patients(eyes)the severe nonproliferative diabetic retinopathy was randomly divided into two groups:the combined group(30 eyes)received the combination treatment of peribulbar injection of triamcinolone acetonide and subthreshold micropulse laser and the control group(30 eyes)received subthreshold micropulse laser only.After subthreshold micropulse laser photocoagulation,the combined group received peribulbar injection of triamcinolone acetonide(20 mg),and also received every 4 weeks.One week after subthreshold micropulse laser photocoagulation,two groups of patients received panretinal photocoagulation.Central macular thickness,macular sensitivity and best corrected visual acuity(BCVA)were measured before the treatment,were also measured at one month,three months and six months after the treatment.Results Central macular thickness was significantly reduced after treatment in both groups(F=74.082,P<0.05),and the decrease was more obvious in the combination group(F=4.033,P<0.05).Macular sensitivity and BCVA significantly increased after treatment in both groups(both P<0.05).Comparing to pre-treatment,macular sensitivity and BCVA were significantly increased at 1 month after treatment in the combined group(both P<0.05),6 months in the control group for macular sensitivity and 3 months for BCVA(both P<0.05).Conclusions Subthreshold micropulse laser can reduce macular edema,improve macular retinal sensitivity and improve visual acuity.The treatment of peribulbar injection of triamcinolone acetonide can speed up recovery.

关 键 词:糖尿病性黄斑水肿 曲安奈德 阈下值微脉冲激光 

分 类 号:R77[医药卫生—眼科] R587[医药卫生—临床医学]

 

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