532激光联合TA后Tenon＇s囊下注射治疗弥漫型DME

532 laser photocoagulation combined with posterior sub-Tenon injection of triamcinolone acetonide in treatment of diffused diabetic macular edema

目的:研究弥漫型糖尿病黄斑水肿(DME)患者全视网膜光凝(PRP)前,予以TA(曲安奈德注射后Tenon's囊下)治疗的临床效果。方法:回顾分析我院2008-10/2012-05以来,于我科治疗的96例96眼弥漫型DME患者临床资料,依据治疗方式将其分为研究组与对照组,每组48例48眼,对照组仅予以PRP治疗,研究组PRP 1wk前,予以TA治疗,在6mo后对比两组BCVA(最佳的矫正视力)及视网膜厚度改变情况,对两组眼压变化予以分析。结果:经治疗后,两组6mo随访发现,对照组同治疗前相较,其BCVA呈降低表现,研究组呈升高表现,两组具有明显差异(P<0.05),并且在随访期内,两组患者眼压均在正常范围内波动变化,不具差异(P>0.05),研究组黄斑中心凹厚度降低9.6μm,对照组增高31.9μm,呈明显差异(P<0.05),研究组旁中心凹厚度降低5.0μm,对照组增加22.1μm,呈明显差异,研究组中心凹周边厚度增加0.4μm,对照组增加19.4μm,不具差异(P>0.05)。结论:弥漫型DME患者PRP前,予以TA治疗,安全有效,并且优于单纯进行PRP治疗,可以在基层医院推广实施。

AIM：To study the effect of posterior sub-Tenon＇s capsule injection of triamcinolone acetonide（TA）in treatment of patients with diffuse diabetic macular edema（DME）before panretinal photocoagulation（PRP）.METHODS：Retrospective analysis of the clinical data of 96 cases（96 eyes）with DME treated in our hospital from October 2008 to May 2012, and the patients were divided into the study group and control group, each group with 48 cases（48 eyes）, the control group were only treated with PRP, and for the study group, TA was injected one week before PRP. At 6mo after treatment, best-corrected visual acuity（BCVA）and retinal thickness changes of two groups were compared, the changes of intraocular pressure in two groups was analyzed. RESULTS：After treatment, two groups were followed up for 6mo, compared with before treatment, the expression of BCVA in control group was reduced, and rise in the study group, with significant difference between the two groups（P〈0.05）, and during the follow-up period, IOP change was in the normal range for the two groups, with no the difference（P〉0.05）, the study group had foveal thickness reduction of 9.6μm, the control group was increased by 31.9μm, with significant difference（P〈0.05）, parafoveal thickness in the study group decreased 5μm, significantly increased 22.1μm in the study group, centre concave surrounding thickness increased 0.4μm in study group and 19.4μm for the control group, with no significant difference（P〉0.05）. CONCLUSION：TA injection in patients with diffuse DME before PRP is safe and effective, and it is superior to simple PRP therapy, and it can be applied in primary hospital.