曲安奈德球后注射联合激光光凝治疗视网膜静脉阻塞继发黄斑水肿

Retrobular injection of triamcinolone acetonide combined with laser photocoagulation for macular e dema secondary to retinal vein occlusion

目的评价球后注射曲安奈德联合激光光凝治疗视网膜静脉阻塞继发黄斑水肿的疗效。方法视网膜静脉阻塞继发黄斑水肿46例（46眼）中，23眼进行单纯激光治疗，另23眼球后注射曲安奈德联合激光光凝治疗。随访3～6个月，观察治疗前后视力、眼底、眼压及荧光素眼底血管造影的变化。结果经治疗，药物联合激光组视力提高14眼（60．9％），视力不变为5眼（21．7％），视力下降4眼（17．4％），水肿减轻19眼（82．6％），水肿未退4眼（17．4％）。单纯光凝组视力提高5眼（21．7％），视力不变13眼（57．6％），视力下降5眼（21．7％），水肿减轻8眼（34．8％），水肿未退15眼（65．2％）。视力提高和水肿消退情况，联合组均优于单纯激光组（P〈0．05）。所有患者均未出现球后出血、眼内炎、白内障或视网膜脱离等并发症。结论激光光凝治疗视网膜静脉阻塞继发黄斑水肿时联合球后注射曲安奈德可促进水肿吸收和视力改善。

Objective To observe the effect of retrobular injection of triamcinolone acetonide （TA） combined with laser photocoagulation for macular edema secondary to retinal vein occlusion. Methods For ty six patients （46 eyes） with macular edema due to retinal vein occlusion ,23 eyes of them were treated with only laser photocoagulation and the rest were treated with retrobular injection of TA combined with laser pho tocoagulation. Visual acuity and fundus fluorescein angiography were measured. Results After treatment, a- mong patients with retrobulbar injection TA combined with laser photocoagnlation, visual acuity improved in 14 eyes （60.9%） ,unchanged in 5 eyes （21.7%） ,declined in 4 eyes （ 17.4% ） ,and edema reduced in 19 eyes （ 82.6% ） ,unchanged in 4 eyes （ 17.4% ）. Among patients only with retrobulbar injection TA,visual a cuity improved in 5 eyes （21.7%） ,unchanged in 13 eyes （57.6%） ,declined in 5 eyes （21.7%） ,and e- dema reduced in 8 eyes （34.8%） ,unchanged in 15 eyes （65.2%）. All patients were not found with com plications of retrobulbar hemorrhage, endophthalmitis, cataract, retinal detachment. Conclusion Retrobulbar injection TA combined with laser photocoagulation can promote the absorption of macular edema and the visu al acuity improvement.