曲安奈德后Tenon囊下注射治疗糖尿病黄斑水肿的临床研究

The clinic study of the posterior sub-Tenon injection triamcinolone acetonide to treat diabetic macular edema

目的总结后Tenon囊下注射曲安奈德治疗糖尿病性黄斑水肿(DME)的短期疗效。方法收集门诊确诊DME病人25例,同时接受后Tenon囊下注射曲安奈德(20 mg/0.5 mL),治疗前和注射后4周定期进行门诊回访观察,包括:国际标准对数视力表检查最佳矫正视力(BCVA)、光学相干断层成像(OCT)计算中心视网膜平均厚度、眼压检查。结果术后第1周最佳矫正视力提高2行以上有9只眼(30%,P<0.05),第4周有11只眼(36.7%,P<0.05)。平均最佳矫正视力统计学有提高;平均中心视网膜厚度(CRT)治疗前为(411±170)μm:治疗后1周(349±102)μm(P<0.05),治疗后4周(360±159)μm(P<0.05)。治疗前眼压平均值为(15.6±3.2)mm Hg,治疗后第1周为(16.3±5.6)mm Hg(P>0.05),治疗后4周为(15.5±2.8)mm Hg(P>0.05),观察期间没有发现与注射药物相关的眼科并发症。结论对DME进行后Tenon囊下注射曲安奈德后,短期观察最佳矫正视力和中心视网膜厚度均有变化。

Objective To report the efficacy of the posterior sub-Tenon injection triamcinolone acetonide to treat diabetic macular edema（DME） in the short-term.Methods Medical records of 25 eyes of 25 patients who underwent posterior sub-Tenon injections of triamcinolone acetonide for persistent diabetic macular edema were reviewed retrospectively.All eyes received triamcinolone acetonide（20 mg/0.5 ml）.The clinical course of best-corrected visual acuity（BCVA） using a logarithm of the minimum angle of resolution chart,and averaged foveal retinal thickness using an optical coherence tomography（OCT） were monitored for up to four weeks after the injection and IOP.Results BCVA at one week improved by two lines or more in nine eyes（30%,P0.05） and in eleven eyes（36.7%,P0.05） at four weeks.significant improvement in the mean BCVA from baseline was observed.Mean central retinal thicknesses（CRT） were 411±170 μm at baseline,349±102 μm at one week after the injection（P0.05）,and 360±159 μm at four weeks（P0.05）.after the injection,significant regression of macular edema was seen.No complications such as IOP,severe vision loss,endophthalmitis,or systemic events developed.Conclusion This study shows changes in BCVA and CRT were observed in the short-term observation after the posterior sub-Tenon injection of triamcinolone acetonide for DME.