TA联合激光治疗视网膜静脉阻塞黄斑水肿的临床观察

Clinical effect of intravitreal triamcinolone acetonide combined with laser photocoagulation on macular edema with retinal vein occlusion

目的:观察玻璃体腔内注射曲安奈德联合激光光凝治疗视网膜静脉阻塞引起的黄斑水肿的有效性和安全性。方法:患者38例38眼经眼底镜检查、眼底荧光素血管造影(fundus fluorescein angiography,FFA)及光学相干断层扫描(optical coherence tomography,OCT)检查明确诊断的视网膜静脉阻塞引起的黄斑水肿,玻璃体腔内注入曲安奈德4mg(0.1mL),术后1～2mo时行视网膜激光光凝,随访3～9mo,观察视力、眼压、眼底情况及视网膜厚度变化。结果:视力提高36眼,视力无变化2眼。视力<0.1者3眼,0.1～0.3者11眼,0.3～0.5者17眼,>0.5者7眼。4例患者眼压不同程度升高,予以局部降眼压药物治疗后,术后2～5mo眼压恢复正常,未发生1例视网膜毒性反应。结论:曲安奈德联合激光可以安全、有效治疗视网膜静脉阻塞引起的黄斑水肿,提高患者视功能。

AIM： To determine the efficacy and safety of intravitreal triamcinolone acetonide （ TA ） combined with laser photocoagulation in macular edema caused by retinal vein occlusion. METHODS. Thirty-eight macular edema eyes of 38 patients with retinal vein occlusion were diagnosed by ophthalmoscopy,FFA and OCT. All patients received an intravitreal injection of 4rag of TA C0. lmL） and photocoagulation after 1-2 month （ s 7. The changes of vision, ocular tension, ocular fundus and retinal thickness were observed for 3-9months. RESULTS： Visual acuity was improved in 36 eyes, remained stable in 2 eyes. Visual acuity less than 0.1 were in 3 eyes, 0.1-0.3 in 11 eyes, 0.3-0.5 in 17 eyes, more than 0.5 in 7eyes. Ocular tension increased in 4 cases in different extent and put back in 2-5 months after given ocular hypotensive agents. No one occurred retinal toxic reaction . CONCLUSION： Intravitreal TA combined with laser photocoagulation is an efficient and safe treatment in macular edema caused by retinal vein occlusion, it can improve the visual acuity remarkablely.