后Tenon囊下注射曲安奈德联合格栅样光凝治疗视网膜分支静脉阻塞黄斑水肿的临床疗效观察

Clinical effects of posterior sub-tenon's injection of triamcinolone acetonide and grid pattern photocoagulationon the treatment of branch retinal vein occlusion with macular edema

目的观察后Tenon囊下注射曲安奈德(TA)联合格栅样光凝治疗视网膜分支静脉阻塞(BRVO)黄斑水肿的临床疗效。方法选择我院门诊2009年5月至2011年l0月缺血型BRVO黄斑水肿眼48例,随机分为两组,激光格栅样光凝治疗组和后Tenon囊下注射TA联合激光格栅样光凝治疗组,两组均先行激光格栅样光凝治疗黄斑水肿,实验组随后行TA40mg后Tenon囊下注射。观测两组治疗前和治疗后3天、l周、1月、3个月时视力、眼压、荧光素眼底血管造影(FFA)。结果所有患眼视力均有不同程度提高,实验组1周内6例视力提高,1,3月同期两组视力提高比较,有显著差异(P<O.05),FFA显示黄斑水肿减轻或消退。2月内暂时性眼压轻度升高6只眼,经局部药物治疗后3个月内均恢复正常。所有患眼未见眼内炎、眼球壁穿孔、眼眶出血等并发症。结论后Tenon囊下注射TA联合黄斑格栅样光凝治疗BRVO黄斑水肿效果明显,恢复快。

Objetive To study the effect of posterior sub-tenon＇s injection of triamcinolone acetonide and grid pattern photocoagulation on the treatment of branch retinal vein occlusion macullar edema. Methods 48 eyes of ischemic BRVO and macular edema from May, 2009 to Aug, 2011 were divided into two groups randomly. Both groups underwent grid pattern photocoagulation. Moreover, study group received posterior sub-tenon＇s injection of 40mg triamcinolone acetonide. All eyes were examined before treatment and throughout the follow-up period for visual acuity ,fluorescein angiography（FA） and intraocular pressure. Results Visual acuity were improved after treatment in both groups. Study group had a better visual acuity than control group （P〈0.05）.The macullar edema had been significantly reduced as measured by FFA. Intraocular pressure was elevated at 2 months after TA injection in 6 eyes and returned to normal at 3 moths with application of drugs. No other complications were observed.Conclusion Posterior sub-tenon＇s injection of TA and grid pattern photocoagulation is effective for reducing branch retinal vein occlusion macullar edema.