摘要
目的探讨玻璃体切割术联合曲安奈德(TA)治疗严重增殖性糖尿病视网膜病变(PDR)患者糖尿病性黄斑水肿的疗效。设计回顾性比较性病例系列。研究对象2009年7月至2010年4月中南大学湘雅二医院连续实施玻璃体切割术的严重PDR患者25例(28眼)。方法 12例14眼在玻璃体切除术毕玻璃体内注射曲安奈德(IVTA)2 mg,为IVTA组;13例14眼仅做玻璃体切割,未注射TA,为对照组。用OCT等检查随访观察患者6个月。两组患者术前PDR复杂性评分无差异。主要指标LogMAR最佳矫正视力、OCT黄斑中央厚度。结果术后6个月,IVTA组LogMAR最佳矫正视力(0.76±0.45)显著优于对照组(1.20±0.50)(t=2.473,P=0.020);IVTA组OCT黄斑中央厚度(266.92±50.23μm)显著低于对照组(285.37±46.81μm)(t=16.470,P=0.000)。结论玻璃体切割术联合玻璃体内注射曲安奈德有利于控制严重PDR患者的糖尿病性黄斑水肿和提高视力。
Objective To evaluate efficacy of vitrectomy combined with intravitreal triamcinolone acetonide （IVTA） for diabetic macular edema in patients with severe proliferative diabetic retinopathy （PDR）. Design Retrospective comperative case series. Partici- pants 25 consecutive patients （28 eyes） who underwent pars plana vitrectomy （PPV） for treatment of PDR in the Second Xiangya Hospi- tal of Central South University from July 2007 to April 2010. Methods 12 patients （14 eyes） were allocated into the IVTA group re- ceived an intravitreal injection of 2 mg （0.05 ml） of triamcinolone acetonide at the end of surgery. 13 patients （14 eyes） as controls re- ceived only vitrectomy. All the patients were followed up with OCT examination for 6 months.The preperative complexity score of PDR was similar between two groups. Main Outcome Measures LogMAR Best-corrected visual acuity （BCVA）, central macular thickness （CMT）. Results At 6-month follow-up, mean post-operative BCVA- LogMAR was significantly better in IVTA group （0.76±0.45） than the control （1.20±0.50） （t= 2.473, P=0.020）. The significant reduction of central macular thickness was observed in the IVTA group （266.92± 50.23 μm） compared with the control （285.37±46.81μm） （t=16.470, P=0.000）. Conclusions Pars plana vitrectomy combined with IVTA for the treatments of diabetic macular edema in severe PDR is effective and can improve BCVA better. （Ophthalmol CHN, 2012, 21： 248-252）
出处
《眼科》
CAS
2012年第4期248-252,共5页
Ophthalmology in China
