玻璃体腔注射TA联合激光治疗非缺血型CRVO继发黄斑水肿

Intravitreal injection of triamcinolone acetonide combined with retinal photocoagulation for cystoid macular edema associated with nonischemic central retinal vein occlusion

目的:评价玻璃体腔注射曲安奈德(intravitreal triamcinolo-ne acetonide,IVTA)联合激光治疗非缺血型视网膜中央静脉阻塞继发黄斑水肿的临床效果。方法:将非缺血型视网膜中央静脉阻塞继发黄斑水肿56眼随机分为两组:IVTA联合532半导体激光黄斑部光凝(治疗组)30眼,单独行532半导体激光黄斑部光凝治疗(对照组)26眼。每组在治疗前后查最佳矫正视力、眼压、眼底荧光血管造影(fluorescein fundus angiography,FFA)了解黄斑部荧光渗漏情况、光学相干断层扫描(optic coher-ent tomography,OCT)测量黄斑区视网膜厚度变化。治疗组为先行黄斑格栅样光凝,2wk后进行IVTA4mg。结果:治疗后3mo时,在治疗组中,23眼(77%)视力提高,7眼(23%)视力不变;FFA示黄斑部荧光渗漏明显减轻;黄斑中心凹平均厚度为(170±32)μm。在对照组中,15眼(58%)视力提高,11眼(42%)视力不变;FFA示黄斑部荧光渗漏减轻;黄斑中心凹平均厚度为(223±57)μm。两组视力变化及黄斑中心凹平均厚度改变比较差异有统计学意义(χ2=4.20,χ2=5.13,P<0.01)。结论:IVTA联合激光治疗非缺血型视网膜中央静脉阻塞继发黄斑水肿效果较好。

AIM： To investigate the efficacy of intravitreal triamcino- lone acetonide （IVTA） combined with retinal laser photo- coagulation for the treatment of cystoid macular edema （CME） associated with nonischernic central retinal vein occlusion （ CRVO）. METHODS： Fifty-six eyes of CME associated with noni- schemic CRVO were divided into two groups randomly. IVTA combined with retinal laser photocoagulation group （treat-ment group）; 30 eyes. Laser photocoagulation group （control group）;26 eyes. Best-corrected visual acuity （BCVA）, intraocular pressure （lOP）, fluorescein fundus angiography（FFA） and optic coherent tomography （OCT） before treatment and at 3 month after treatment in these eyes were examined. 40mg/mL IVTA with were performed after 2 weeks of grid pattern retinal laser photocoagulation for CME associated with nonischemic CRVO.RESULTS： Three months after treatment, 23 eyes （77%） had improved BCVA, 7 eyes （23%） remained the same. Fluorescence leakage relieved had been found by FFA. The average retinal thickness of macular area was （170 ±32）μm in treatment group. 15 eyes （58%） had improved BCVA, 11 eyes （42%） remained the same. Relief of fluorescence leakage was found by FFA. The average retinal thickness of macular area was （223 ±57）μm, in control group. There was statistical significant diffe-rence between treatment group and control group （X^2 = 4. 20,X^2 =5.13,P〈 0.01 ）.CONCLUSION： IVTA combinated with retinal laser photocoagulation for the treatment of CME associated with nonischemic CRVO has better efficacy than retinal laser photocoagulation.