不同疗法治疗视网膜静脉阻塞所致黄斑水肿的疗效评价
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Evaluation of curative effect of macular edema in retinal vein occlusion
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    摘要:

    目的:比较普通治疗和玻璃体腔注射曲安奈德(TA)治疗视网膜静脉阻塞所致黄斑水肿的疗效。

    方法:经眼科常规检查,眼底荧光造影(FFA)和光学相干断层扫描(OCT)确诊的视网膜静脉阻塞所致黄斑水肿共75例,患者被分成普通治疗组(血塞通、葛根素静点2wk+山莨蓉碱、地塞米松球后注射1wk+出院后口服活血化瘀类药物12wk)和玻璃体腔注射TA组(血栓通、葛通素静点2wk+抗生素滴眼液滴眼3d+玻璃腔注射TA+出院后口服活血化瘀药物12wk)。普通治疗组31例,玻璃体腔注射TA组44例,两组在术前年龄,病程,眼压,最佳矫正视力(BCVA),中心视网膜厚度(CMT)方面无统计学差异,比较治疗后4,12wk眼压,BCVA,CMT,的改变。

    结果:普通治疗组和玻璃体腔注射TA组在治疗后12wk均改善中心视网膜厚度,玻璃体腔注射TA组较普通治疗组效果显著。4,12wk均能改善视力,组间无显著差别。玻璃体腔注射TA组术后4wk眼压升高(>5mmHg),组间显著差异,12wk眼压回落,组间无显著差异。

    结论:普通治疗组和玻璃体腔注射TA组均能明显减轻视网膜静脉阻塞所致黄斑水肿,改善视力,但是术后眼压升高值得注意。

    Abstract:

    AIM: To compare the efficiency of intravitreal injection of triamcinolone acetonide(TA)or general treatment for the treatment of macular edema in retinal vein occlusion.

    METHODS: Seventy-five eyes of 75 patients with macular edema of retinal vein occlusion were diagnosed by examination of regular inspection, fundus fluorescein angiography(FFA)and optic coherence tomography(OCT). There were 31 patients in general treatment group and 44 patients in TA group. There were no significant differences between the two groups with regards to patient's age, duration of disease, intraocular pressure(IOP), best-corrected visual acuity(BCVA), central macular thickness(CMT)at baseline. Comprehensive ophthalmic evaluation was performed at baseline and at week 4 and 12 after treatment. Main outcome measures included IOP, BCVA and CMT by OCT.

    RESULTS: Separate within-group analysis of showed significant reduction in CMT from baseline in TA group at week 12. The results showed significant improvement in BCVA in TA group and general treatment group. But no significant interaction between groups were observed of BCVA at week 4 and 12. There was a significant increase in IOP(>5mmHg)in the TA group when compared with the general treatment group at week 4, but no significant interaction between groups at week 12.

    CONCLUSION: The result shows that general approach and intravitreal injection of triamcinolone acetonide are well tolerated wiht a significant improvement in BCVA and decrease in macular edema in retinal vein occlusion. But we must be attention to the increased IOP after intravitreal injection of TA.

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侯长军,刘芳.不同疗法治疗视网膜静脉阻塞所致黄斑水肿的疗效评价.国际眼科杂志, 2013,13(12):2446-2448.

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  • 收稿日期:2013-09-06
  • 最后修改日期:2013-11-19
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  • 在线发布日期: 2013-11-25
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