摘要
目的:观察玻璃体腔内曲安奈德(triamcinolone acetonide TA)注射治疗视网膜静脉阻塞引起的黄斑水肿的疗效并进行分析。方法:检眼镜、光学相干断层扫描(OCT)、荧光素眼底血管造影(FFA)检查证实的由视网膜静脉阻塞引起的黄斑水肿患者42例42只眼,玻璃体内注射40g/L的TA0.1ml,随访3～6个月,观察视力、眼压、晶状体、炎症反应、眼底情况,OCT观察视网膜厚度改变,FFA观察眼底毛细血管渗漏情况,对视力和视网膜厚度进行随机区组设计方差分析。结果:治疗前视力为0.15±0.16,治疗后3个月,平均视力为0.40±0.27,视力提高3行以上者33眼,提高3行以内者5眼,不变者4眼,与治疗前相比,差异有统计学意义(P<0.05)。治疗前视网膜厚度平均值为(745±241)μm,治疗后为(259±129)μm,与治疗前相比,差异有统计学意义(P<0.05)。42例患眼中,3例治疗后出现眼压一过性升高,未行药物或手术治疗,眼压降至正常范围。因3个月后黄斑水肿复发,再次注药者3眼,其中1例并发白内障,行白内障手术。FFA提示渗漏明显减轻。无玻璃体出血、视网膜脱离和眼内炎等严重并发症。结论:玻璃体腔内注射TA4mg可以明显减轻由静脉阻塞引起的黄斑水肿,并提高患者视力,是一种有效可行的方法。缺血型患者黄斑水肿易复发,可以考虑玻璃体腔内重复注药,但其远期疗效和并发症需进一步观察。
Objective：To evaluate the effect of intravitreous injection with triamcinolone acetonide （TA） on macular edema caused by retinal vein occlusion. Methods：Examined by opthalmoscopy,optic coherent tomography （OCT）, and fundus fluorescein angiography （FFA） ,42 patients （42 eyes） with macular edema caused by retinal vein occlusion were intravitreously injected with 0.1 ml TA （40 g/L）. During the 3-6 months follow-up period, the visual acuity, intraocular pressure （1OP）,inflammatory extent, manifestation of lens and fundus were observed,the retinal thickness was examined by OCT,and vascular leakage was detected by FFA. The visual acuity and retinal thickness were analyzed by ANOVA for Randomized Block Design. Results：After 3 months treatment,the average visual acuity was 0.40±0.27,which improved 3 lines in 33 eyes and not changed in 4 eyes,while the visual acuity was 0.17±0.17 before treatment,the difference was statistically significant （P 〈 0.05）. The average macular thickness was（332.3±196.5）μm 3 months after treatment, while the macular thickness was （537.4±201.6） μm before treatment, the difference was statistically significant （P 〈 0.05）. Three patients who recurred macular edema after 3 months were injected again,one occurred cataract . Three patients had the temporary high IOP （〉21 mm Hg）,and returned to normal IOP in 1 week without any drugs. The result of FFA showed less leakage of fluorescein after treatment. There were no severe complications such as vitrous hemorrhage,retinal detachment and endophthalmitis. Conclusion： Intravitreous injection with 4rag TA can he used to treat macuIar edema from retinal vein occlusion effectively,and improve the visual acuity. In those ischemic retinal vein occlusion patients who have recurrent macular edema,TA can be reinjected,but the long-term curative effects and complications should be further observed.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2009年第11期1603-1606,共4页
Journal of Nanjing Medical University(Natural Sciences)
基金
江苏省高校自然科学基金(08KJD310002)
关键词
黄斑水肿
视网膜静脉阻塞
曲安奈德
macular edema
retinal vein occlusion
triamcinolone acetonide
