氟羟氢化泼尼松玻璃体腔注射治疗视网膜静脉阻塞继发性黄斑水肿的临床观察

The clinical observation for Triamcinolone acetonide vitreous injection on retinal vein occlusion secondary macula edema

目的:评价玻璃体腔注射氟羟氢化泼尼松(triamcinolone acetonide,TA,曲安奈德)治疗视网膜静脉阻塞(retinal vein occlusion,RVO)继发性黄斑水肿的疗效及安全性。方法:对经间接检眼镜、荧光素眼底血管造影(FFA)、光学相干断层扫描(OCT)检查确诊的RVO继发黄斑水肿患者42例(42眼)行玻璃体腔注射TA0.1ml(4mg),治疗后随访6个月,观察术前及术后不同时期视力、眼压、眼底、FFA表现,观察OCT显示黄斑水肿高度。结果:中央视网膜静脉阻塞(CRVO)25眼(缺血型17眼,非缺血性8眼),分支静脉阻塞(BRVO)17眼(缺血型11眼,非缺血性6眼)。最终随访视力提高30眼,比术前降低5眼,不变7眼。OCT形态恢复正常16眼,改善23眼,无改善3眼。11例术后出现一过性眼压升高,1例术后出现晶体后囊TA药物颗粒贴附,1个月后逐渐吸收。结论:玻璃体腔注射TA是一种安全有效的治疗视网膜静脉阻塞继发黄斑水肿的方法。

Objective：To evaluate the effect and safety of TriamcinoloneAcetonide（TA） vitreousinjectiononretinalveinocclusionsecondary macula edema. Methods： Forty-two cases（ 42 eyes） with retinal vein occlusion secondary macula edema were diagnosed with indirective ophthalmoscope, fluorescence fundus angiography （ FFA） and optical coherence tomography（ OCT） ,and of which received TA 0. 1ml（ 4mg） vitreous injection. The visual acuity,intraocular pressure,fundus,FFA,and OCT on macula were examined before-and after-operation,and with 6 months follow-up. Results： Twenty-five eyes with central retinal vein occlusion（ 17 eyes with ischemic central retinal vein occlusion and 8 eyes with un-ischemic） ,17 eyes with branch retinal vein occlusion（ 11 eyes with ischemic central retinal vein occlusion and 6 eyes with un-ischemic） . By the end of follow-up,visual acuity increased in 30 eyes,no changed 7 eyes,and decreased 5 eyes. The pattern of OCT recovered in 16 eyes ,improved in 23 eyes,no improved in 3 eyes. Intraocula pressure increased temporary was fund in 11 cases. In 1 case,TA granule attached to post-capsula and disappeared after 1 month. Conclution： TA vitreous injection is safe and effective for retinal vein occlusion secondary macula edema.