摘要
目的评价玻璃体内注射曲安奈德(TA)治疗黄斑水肿的疗效和安全性。方法符合入选条件的黄斑水肿患者37例41只眼,其中,视网膜静脉阻塞(RVO)组21例21只眼、糖尿病视网膜病变(DR)组13例17只眼、其他原因组3例3只眼。治疗前3组的平均视力分别为0.07、0.06、0.08。光相干断层扫描(OCT)检查显示,RVO组和DR组黄斑中心凹平均厚度分别为(974±394)、(873±213)μm。均采用40mg/ml的TA0.1ml玻璃体内注射。用药后平均随访8个月,对比观察用药前后的视力、眼压、晶状体及眼底改变以及OCT检测的黄斑区视网膜厚度变化。结果41只眼中,除1只眼视力无变化外,其余眼视力均有不同程度提高。3组患者用药后6个月时随访,平均视力分别上升至0.25、0.20和0.35。全部治疗眼临床检查均显示黄斑水肿减轻或消退,OCT检查显示,RVO组和DR组治疗后1个月时,黄斑中心凹平均厚度分别为(173±41)、(204±76)μm。与治疗前比较,差异有统计学意义(t值分别为8.323和6.842,P值均<0.01)。6只眼眼压高于21mmHg(1mmHg=0.133kPa),占14.6%。眼压升高发生于用药后1周至2个月,经局部用β受体阻滞剂眼压均能控制正常。1只眼白内障发展;另有1例糖尿病玻璃体切割手术后黄斑水肿患者,用药2个月后出现黄斑裂孔。RVO组和DR组中各有2只眼因黄斑水肿复发,在第一次用药后4~5个月再次玻璃体内注射TA0.1ml。结论玻璃体内注射TA对于常规治疗无效的黄斑水肿有一定疗效;一过性眼压升高是最常见的不良反应。尚需进一步评价其长期疗效和安全性。
Objective To evaluate the efficacy and security of intravitreous injection withtriamcinolone acetonide(TA)for macular edema.Methods A total of 41 eyes in 37 patients withmacular edema who measured up were collected,including 21 eyes of 21 cases in retinal vein occlusion(RVO)group.17 eyes of 13 cases in diabetic retinopathy(DR)group,and 3 eyes of 3 cases in the other-causes group.Before the treatment,the average visual acuity was 0.07,0.06,and 0.08 in the 3 groupsrespectively,and the mean thickness of macular fovea detected by optic coherence tomography(OCT)was(974±394)and(873±213)in RV(O)and DR group,respectively.Intravittreous injection with 0.1 ml TA(40 mg/ml)was performed on each patient.The average follow-up duration was 8 months after thetreatment.The visual acuity,intraocular pressure(IOP),changes of lens and ocular fundus,and retinalthichness at macular area before and after the treatment was observed and compared.Results All eyesexcept one had improved visual acuity.The mean visual acuity improved to 0.25,0.20,and 0.35 in the 3groups respectively 6 months after the treatment.Alleviated or reducing macular edema was found in all ofthe patients.The average retinal thickness at macular fovea was(173_±41)and(204±76)in RVO andDR group respectively 1 month after the treatment,which had statistical significance compared with thatbefore the treatment(t=8.323,6.842;P<0.01).The intraocular pressure was>21 mm Hg(1 mm Hg=0.133 kPa)in 6 eyes(14.6%),which mostly happened 1 week to 2 months after theinjection,and was controlled to normal level after partially treated with p-receptor retarder.The cataractdeveloped in 1 eye,and another patient with macular edema after vitrectomy due to diabetes had macularhole 2 months after the injection.There were 2 eyes underwent intravitreous injection with 0.1 ml TA 4-5 months after the first treatment due to the recurrence of macular edema in RVO and DR groupConclusions Intravitreous injection with TA is a promising therapeutic method forrespectively.macular edema that fails to respond to conventional treatment.Transient elevation of ocular pressure is themost common side effect.Further study is needed to assess the long-term efficacy and safety.
作者
常青
王文吉
CHANG Qing;WANG Wen-ji(Shanghai Eye&.ENT Hospital of Fudan University.Shanghai 200031,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2005年第4期209-212,共4页
Chinese Journal of Ocular Fundus Diseases
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/投药剂量
Macular edema,cystoid/drug therapy:Triamcinolone acetonide/therapeutic use
Triamcinolone acetonide/administration&.dosage
