小剂量曲安奈德玻璃体腔注射治疗静脉阻塞黄斑水肿疗效观察

Curative effect of small doses of triamcinolone acetonide in vitreous body cavity injection treatment on retinal vein occlusion macular edema

目的探讨小剂量曲安奈德(TA)玻璃体腔注射治疗视网膜静脉阻塞(RVO)黄斑水肿的效果和安全性。方法 32例(32眼)RVO黄斑水肿患者随机分为观察组和对照组,每组16例(16眼)。2组患者均行玻璃体腔注射术,其中观察组患者玻璃体腔注射TA 1 mg,对照组患者玻璃体腔注射TA 4 mg。比较2组患者手术前后视力、黄斑区视网膜厚度及眼压变化。结果 2组患者术后1周及1、3个月视力与术前比较均显著升高(P<0.05),黄斑区视网膜厚度较术前均显著降低(P<0.05),但2组患者治疗后视力及黄斑区视网膜厚度比较差异均无统计学意义(P>0.05)。对照组患者术后1周及1、3个月眼压较术前均显著升高(P<0.05),观察组患者术后1周及1、3个月眼压与术前比较差异无统计学意义(P>0.05),对照组患者术后1周及1、3个月眼压较观察组均显著升高(P<0.05)。结论小剂量TA玻璃体腔注射治疗RVO黄斑水肿有效,且不增加患者眼压,安全性好。

Objective To investigate the curative effect and security of small doses of triamcinolone acetonide（TA） in vitreous body cavity injection treatment on retinal vein occlusion （RVO） macular edema. Methods A total of 32 cases （32 eyes） of RVO patients with macular edema were divided into observation group and control group randomly,with 16 cases （16 eyes） in each group. The patients in the two groups were accepted vitreous body cavity injection. The patients in observation group were given TA 1 mg while the patients in control group were given TA 4 rag. The visual acuity, macular region retinal thickness changes and intraocular pressure before and after treatment of the two groups were compared. Results Compared with before treatment, the visual acuity increased significantly while the macular region retinal thickness decreased significantly one week, one month and three months after treatment in observation group and control group（ P 〈 0.05 ） , but there was no sig- nificant difference in the visual acuity and macular region retinal thickness between the two group after treatment （P 〉 0.05）. The intraocular pressure at one week, one month and three months after treatment in control group was increasing compared with that before treatment（ P 〈 0.05 ） ,while there was no significant difference of intraocular pressure in observation group be- fore and after treatment（P 〉 0.05 ）. The intraocular pressure in control group increased significantly than that in observation group at one week, one month and three months after treatment （ P 〈 0.05 ）. Conclusion Small doses of TA in vitreous body cavity injection treatment on RVO macular edema is effective without increasing intraocular pressure of the patients and its se- curity is good.