玻璃体腔注射曲安奈德治疗糖尿病性视网膜病变黄斑水肿

Intravitreal injection of triamcinolone acetonide for macular edema due to diabetic retinopathy

目的:研究玻璃体腔注射曲安奈德(triamcinolone ace-tonide,TA)治疗糖尿病视网膜病变黄斑水肿的有效性。方法:2004-06/2006-01确诊的31例(34眼)糖尿病性视网膜病变黄斑水肿患者,行玻璃体腔注射TA(4mg/0.1mL)治疗。对比分析治疗前后三个参数:最佳矫正视力、OCT检测黄斑中心凹厚度、眼压。随访时间3～10(平均6)mo。结果:患者31例(34眼),年龄50～75(平均63)岁。OCT检测黄斑中心凹厚度治疗前平均518±95μm,治疗随访6mo后平均220±89μm(P<0.05);最佳矫正视力范围治疗前为4.0～4.5,平均4.0±0.15,治疗后为4.1～4.6,平均4.3±0.15(P>0.05);所有患者眼压都有升高,升高值2.0～4.5(平均3.5)mmHg(P>0.05),但都在正常眼压范围之内。没有其他并发症发生。结论:玻璃体腔注射TA是治疗糖尿病性视网膜病变黄斑水肿的有效方法,但患者的视力没有明显的提高。

AIM： To evaluate the therapeutic effect of intravitreal injection of triamcinolone acetonide （TA） in the treatment for macular edema associated with diabetic retinopathy. METHODS： A total of 31 patients （34 eyes） diagnosed with macular edema due to diabetic retinopathy from June 2004 to January 2006 were enrolled in the study. These patients underwent intravitreal injection of triamcinolone acetonide （4mg/0. lmL）. Best corrected visual acuity, macular foveal thickness by optical coherence tomography （ OCT）, and intraocular pressure （IOP） were measured before and after treatment and compared and analyzed. The follow-up period ranged from 3 months to 10 months with a mean of 6 months. RESULTS： The age of patients ranged from 50 to 75 （mean 63） years. The macular foveal thickness was 518 ± 95μm on average measured by OCT before the treatment and decreased to a mean of 220 ± 89μm at 6 months after injection of TA （P〈0.05）. The mean postoperative best corrected visual acuity was 4. 3 ± 0. 15, which was slightly improved than preoperative vision （mean 4.0 ± 0.15 ）, but there was no statistical significance （ P 〉 0.05）. The IOP of all patients were increased, and the scope of IOP elevation was from 2.0 to 4.5 （ mean 3.5） mmHg. However, IOP of all patients were within the normal range before and after the treatment. CONCLUSION： Intravitreal triamcinolone acetonide injection seems to be a promising treatment option for macular edema from diabetic retinopathy, but the visual acuity of patients were not significantly improved.