摘要
目的观察玻璃体内注射曲安奈德(TA)治疗黄斑水肿的效果。方法经检眼镜、光相干断层扫描(OCT)或(和)视网膜厚度分析仪(RTA)及荧光素眼底血管造影(FFA)检查证实的糖尿病、视网膜静脉阻塞所致的弥漫性或(和)囊样黄斑水肿患者33例37只眼,玻璃体内注射40mg/ml的TA0.1ml,随访1~9个月,观察视力、眼压、炎症反应、晶状体、眼底情况,OCT或RTA检查视网膜厚度改变,FFA观察毛细血管渗漏情况。结果治疗后1、2、3个月视网膜厚度分别为(244.07±118.80)、(195.53±57.70)、(181.42±54.79)μm,与治疗前的视网膜厚度(724.35±227.41)μm相比,差异具有统计学意义(t值分别为10.72、12.84、13.90,P值均<0.001)。视力分别为0.39±0.19、0.45±0.24、0.43±0.21,与治疗前的视力0.20±0.16比较,其差异具有统计学意义(t值分别为4.445、4.349、3.474,P值分别为<0.001、<0.001、0.03)。FFA显示治疗后荧光素渗漏明显减少,增生性改变减轻。9例患者眼压≥20mmHg(1mmHg=0.133kPa),其中4例≥25mmHg。3例患者4只眼分别在治疗后4、6个月黄斑水肿复发。未见晶状体混浊加重,无感染发生。结论玻璃体内注射TA可以有效治疗糖尿病、视网膜静脉阻塞所致的黄斑水肿;但有部分患眼黄斑水肿复发、部分患眼出现眼压升高。
Objective To evaluate the effect of intravitreous injection with triamcinolone acetonideMothod Having been examined by ophthalmoscopy,optic coherent(TA)on macular edema.tomography(OCT),retinal thickness analyzer(RTA),and fundus fluorescein angiography(FFA),33patients(37 eyes)with diffused and(or)cystoid macular edema caused by diabetes and retinal venousocelusion were intravitreously injected with 0.1 ml triamcinolone acetonide(40 mg/ml).During 1-9-month follow-up period,the visual acuity,intraocular pressure,inflammatory extent,manifestation oflens and fundus were observed,the retinal thickness was examined by OCT and RTA,and vascularleakage were detected by FFA.Results Macular thickness was(244.07±118.80),(195.53±57.70),and(181.42±54.79)pm respectively 1,2,3 months after treatment;while macular thickness was(724.35±227.41)um before the treatment.The difference was statistically significant(t=10.72,12.84,13.90:P<0.001).The visual acuity was 0.39±0.19,0.45±0.24,and 0.43±0.21 respectively,comparing with the visual acuity before the treatment(0.20±0.16),the difference was statisticallysignificant(t=4.445,4.349,3.474:P<0.001,<0.001,0.03);The result of FFA showed less leakageof fluorescein and proliferative lesion.Four pateints had the ocular pressure≥25 mm Hg(1 mm Hg=0.133 kPa)in 9 who had 220 mm Hg.Recurrence of macular edema was found in 4 eyes of 3 patients 4and 6 months after the treatment,respectively.No infection or aggravation of lenticular turbidnessoccurred.Conclusion Intravitreous injection with TA can be used to treat macular edema due todiabetes and retinal venous occlusion,and recurrence of macular edema or increase of intraocular pressuremay occur in some patients.
作者
徐海峰
董晓光
王伟
陈焓
XU Hai-feng;DONG Xiao-guang;WANG Wei(Shandong Eye Institute,Shandong.266071,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2005年第4期205-208,共4页
Chinese Journal of Ocular Fundus Diseases
基金
青岛市科技局科技计划项目(04-2-NY-51)
关键词
黄斑水肿
囊样/药物疗法
曲安奈德/治疗应用
曲安奈德/投药和剂量
Macular edema,cystoid/drugtherapy
Triamcinolone acetonide/therapeutic use
Triamicinolone acetonide/administration&.dosage
