玻璃体腔注射曲安奈德治疗糖尿病性黄斑水肿的临床观察

Intravitreous injection with triamcinolone acetonide for diabetic macular edema

目的通过对玻璃体腔注射曲安奈德(TriamcinoloneacetonideTA)治疗糖尿病视网膜病变所致黄斑水肿临床结果的分析,评价此种疗法的有效性,安全性。方法15例经眼底检查,荧光素眼底血管造影(FFA)和光学相干断层扫描(OCT)检查确诊的糖尿病黄斑水肿的患者15眼接受玻璃体腔注射40mg/ml曲安奈德0.1ml治疗,随访时间最少3m,最长6m,研究对象包括接受治疗前与治疗后1w,1m,3m和最终随访的最佳校正视力、眼压,接受治疗前与治疗后1m的光学相干断层扫描(OCT)结果。结果接受治疗前最佳校正视力与治疗后1w,1m,3m和最终随访的最佳校正视力相比均无显著性差异(P>0.05),接受治疗前黄斑区视网膜厚度与治疗后1m相比有显著性差异(P<0.01)。结论玻璃体腔注射曲安奈德可以在短期内改善糖尿病视网膜病变所致黄斑水肿患者的视力,加速视网膜下液的吸收,是一种有效的治疗方法。但其长期的治疗效果及临床应用的安全性,反复注射时机的掌握还需要进一步的研究。

Objective To inve.stigate the efficacy and safety of intravitreous injection with triamcinolone acetonide（TA） for diabetic macular edema. Methods Intravitreous injection with 40mg/ml triamcinolone acetonide 0.1 ml was performed on 15 patients with diabetic macular edema who had received ocular-fundus examination, fundus fluorescein angiography, and optical coherence tomography.The follow-up duration was at least 3 months and the longest 6months.The study include the best corrected visual acuity and intraocular pressure before injection and 1 month ,3, and 6 months after injection, and the result of OCT before and after the treatment. Results The best corrected visual acuity before injection and 1 month ,3, and 6 months after injection has no significant difference （ P〉0.05 ）, but the retinal thickness at the macular area before and after the treatment has significant difference （ P〈0.01）. Conclusions Intravitreous injection with triamcinolone acetonide can improve the visual acuity of patients with diabetic macular edema and make the absorption of subretinal fluid more fast. This is a kind of effective treatment. But we need more study about its long time treatment result, clinical safety and the time for another injection.