曲安奈德玻璃体腔注射治疗视网膜分支静脉阻塞继发黄斑水肿

Effects of intravitreal triamcinolone ace-tonide for macular edema secondary to retinal branch vein occlusion

目的:观察玻璃体腔注射曲安奈德(tviamcinolone ace-tonide,TA)治疗视网膜分支静脉阻塞(branch retinal vein occusion,BRVO)继发黄斑水肿的疗效。方法:经眼底检查、荧光眼底血管造影(FFA)、光学相干断层扫描(OCT)检查确诊的BRVO继发黄斑水肿22例(22眼)行玻璃体腔曲安奈德注射,治疗后随访(4.2±0.4)mo,对比治疗前及治疗后1,3mo视力、眼压、眼底、FFA表现、OCT所显示黄斑水肿高度以及黄斑中心凹阈值。结果:治疗的22眼中19眼(82%)视力明显提高,3眼(14%)视力不变,治疗前平均视力0.10±0.06,治疗后1,3mo平均视力分别为0.25±0.12、0.28±0.13,黄斑中心凹厚度(OCT)治疗前平均厚度(519.0±137.5)μm,治疗后1,3mo平均厚度分别为(256.4±68.3)μm、(239.4±52.2)μm,黄斑中心凹阈值(dB):治疗前(18.8±4.2)dB,治疗后1,3mo分别为(24.0±6.0)dB、(24.6±5.2)dB,治疗前后比较差异有统计学意义(P<0.01)。22眼中有6眼(27%)治疗后暂时性眼压升高,经局部抗青光眼药物治疗后恢复正常。5例(23%)患者2次注药。结论:玻璃体腔注射TA在短期内可有效改善BRVO继发黄斑水肿,但也要注意对原发病治疗。

AIM： To evaluate the efficacy of intravitreous injection with triamcinolone acetonide （TA） for macular edema associated with branch retinal vein occlusion（BRVO）. METHODS： Twenty-two eyes of 22 patients with severe macular edema due to BRVO underwent intravitreal injection of TA with 40g/L. The follow-up period was （4.2 ± 0. 36） months. The changes in best-corrected visual acuity, intraocular pressure, central macular thickness and macular threshold sensitivity were compared before treatment and at 1 month and 3months after treatment. RESULTS： In all 22 eyes, 19 eyes （82%） had improved visual acuity, the average visual acuity was 0. 1 - 0. 06 before the treatment; while at 1 month and 3 months after the injection, the average visual acuity increased to 0.25 ± 0.12,0.28 ± 0.13;The central macular thickness before the injection was （519. 0 ± 137. 5）um, while significantly decreased to （256.4 ± 68.3 ） um, （ 239.4 ± 52.2 ） um at 1 month and 3 months after the injection, the mean macular threshold sensitivity was （18.8 ± 4.2） dB before the treatment, while significantly decreased to （24.0 ± 6. 0）dB,（24.6_＋5.2）dB at 1 month and 3 months after the injection, which has a statistically significant difference. 6 eyes （27%） of all 22 eyes showed high intraocular pressure （lOP） temporarily after the treatment, which recovered normal after a local treatment of topical eye drop. 5 eyes （23%） were received a secondary injection of TA. CONCLUSION ： Intravitreal injection of TA is effective for macular edema secondary to BRVO in a short time, but the long-term curative effects and complications should be further observed.