激光联合曲安奈德治疗视网膜分支静脉阻塞性黄斑水肿的临床观察

Clinical Observation of Combined Triamcinolone Acetonide with Laser Photocoagulation for Branch Retinal Vein Occlusion with Maeular Edema

目的:评价视网膜激光光凝联合玻璃体腔曲安奈德注射(IVTA)治疗视网膜分支静脉阻塞(BRVO)性黄斑水肿(ME)的疗效和安全性。方法:52例52眼BRVO性ME患者随机分为两组,联合组26例26眼IVTA(4 mg/0.1 ml)后1周行激光光凝,激光组26例26眼仅行激光光凝。随访6个月观察视力、眼底、黄斑水肿及并发症等。结果:治疗后1、3、6个月随访,两组患者治疗前后最佳矫正视力均提高,差异有统计学意义(P<0.05),联合组视力优于激光组,差异有统计学意义(P<0.05),黄斑中心凹厚度联合组低于激光组(P<0.05),激光组并发症低于联合组(P<0.05)。结论:IVTA联合激光光凝是治疗BRVO性ME的有效方法,尤其是对于光凝治疗无效患者,但其长期疗效和安全性还需进一步观察。

Objective： To evaluate the efficacy and safety of treatment combined intravitreous injection Triamcinolone Acetonide（IVTA） with laser photocoagulation（LP） for branch retinal vein occlusion（BRVO） with maeular edema（ME）.Method： Fifty-two patients（fifty-two eyes） with BRVO with ME were randomly divided into two groups, combination group： twenty-six eyes were treated with IVTA（4 rag/0.1 ml）, and LP was used to treat all of the patients after one week.Laser group： twenty-six eyes were treated with LG.Best-corrected visual acuity（BCVA）, central macular thinckness（CMT） and the incidence of complications were observed after the treatment.Result： For the different follow-up times at one month, three months, six months, BCVA and CMT of all patients improved after treatment, there were statistically significant differences between before treatment and after treatment in BCVA（P〈0.05）.Combination group was better than that of laser group（P〉0.05）.The CMT lowered in the combination group after treatment（P〈0.05）.The difference in the incidence of complications between the two groups showed a statistically significant difference（P〈0.05）.Conclusion： IVTA combined with LP can be an effective method in the treatment of DME, especially for patients which LP treatment is invalid, but its long-term efficacy and safety still need further observation.