后Tenon囊下注射曲安奈德联合改良格栅光凝治疗RVO—ME的疗效观察

目的观察后Tenon囊下注射曲安奈德（PSTA）联合改良格栅光凝治疗视网膜静脉阻塞继发黄斑水肿（RVO—ME）的临床疗效．方法通过眼底照相、眼底血管荧光造影（FFA）及黄斑光学相干断层扫描（OCT）检查确诊的RVO—ME患者27例（27眼）。所有患眼均采用国际标准视力表检测最佳矫正视力（BCVA）。利用OCT测量患眼黄斑中心凹厚度（CMT）。所有患眼均行单次PSTA治疗，注射曲安奈德40mg，1个月后联合532激光行改良格栅光凝治疗。对比患眼治疗后2、3个月BCVA、CMT与治疗前BCVA、CMT的异同以及相关并发症的发生情况。结果治疗后2、3个月，患眼平均BCVA分别为（0．57±0．57）、（0．54±0．41）；比治疗前平均BCVA（0．69±O．63）有所提高，差异有统计学意义（F=5．043，5．274，P〈0．05）。治疗后2、3个月，平均CMT分别为（430．7±297．4）μm、（403．8±2877）μm，较治疗前（617．3±234．2）μm分别降低（186．6±137．3）μm、（213．5±111．6）μm。治疗前后差异均有统计学意义（F=16．143、11．375，P〈0．05）。5眼眼压〉21mmHg患者，通过治疗后均恢复正常。所有患眼均未出现感染、眼球穿通伤等并发症。结论PSTA联合改良格栅光凝治疗RV0-ME有效，可降低患眼CMT，对视力有改善作用，是一种相对安全有效的治疗方案。

Objective To observe the efficacy of posterior sub-tenon injection of triamcinolone acetonide （ PSTA ） combined with modified macular grid laser photocoagulation in the treatment of macular edema due to retinal vein occlusions. Methods A retrospective clinical study. By fundus photography, FFA and OCT diagnosis of patients with RVO-ME 27 eyes of 27 patients were enrolled into the study. All eyes were detected the BCVA by using OCT measurement ofmacular thickness （ CMT ） . All patients had a single row PSTA treatment, injection oftriamcinolone acetonide （ 40mg ） , 1 month after 532 laser combined with modified grid laser photocoagulation treatment. Compared the eyes after 2, 3 months of BCVA, CMT in the cyclosporine treatment prior to the CMT, CMT similarities and related complications. Results The BCVA before treatment was （ 0.69 ± 0.63 ） . BCVA after 2, 3 months was （ 0.57 ± 0.57 ） , （ 0.54±0.41 ） , as compared with before treatment, the post-treatment of BCVA was improved, and the difference was statistically significant （ F=5.043, 5.274, P〈0.05 ） . The CMT before treatment was （ 617.3 ± 234.2 ） um.The CMT after 2, 3months was （ 430.7 ±297.4 ） urn, （ 403.8 ± 287.7 ） um, as compared with before treatment, the post - treatment of CMT averages decreased, and the difference was statistically significant （F=16.143, 11.375, P〈0.05 ） . In this study there were 5 eyes which had a higher intraocular pressure than 21 mmHg were recovered after treatment. All patients had no infection, ocular penetrating injury. Conclusion PSTA combined with modified grid photocoagulation in treatment of RV0-ME is safe and effective, which can reduce the CMT and improve the visual acuity.