后部眼球筋膜囊下注射曲安奈德联合视网膜光凝治疗糖尿病性黄斑水肿

Posterior sub-tenon＇ s injection of triamcinolone acetonide combined with retinal photocoagulation for the treatment of diabetic macular edema

目的评价后部Tenon囊下注射曲安奈德联合视网膜光凝治疗糖尿病性黄斑水肿的效果。 方法对56例（90眼）糖尿病性黄斑水肿实施后Tenon囊下注射曲安奈德20 mg，1周后行视网膜光凝，分别于注射后1个月和3个月观察视力、荧光素眼底血管造影（FFA）和黄斑区相干光断层扫描（OCT）情况，分析视力和黄斑水肿的变化。 结果随访1～18个月，平均（7.50±2.30）个月。光凝后视力提高者31眼，占34.4%；无变化者55眼，占61.1%；减退者4眼，占4.4%。黄斑水肿消失者11眼，占12.2%；明显减轻者31眼，占34.4%；减轻者32眼，占35.5%；无变化者10眼，占11.1%；水肿加重者6眼，占6.7%。 结论后Tenon囊下注射曲安奈德有助于减轻视网膜水肿，降低PRP所需能量，减少并发症，从而保护视网膜的功能。

ObjectiveTo evaluate the efficacy of posterior sub-tenon’s injection of triamcinolone acetonide （TA） combined with retinal photocoagulation for the treatment of diabetic macular edema. MethodsNinty eyes of 56 patients with diabetic macular edema were treated with posterior sub-tenon’s injection of 20 mg TA, and then all cases received retinal photocoagulation （RP） 1 week after injection. Visual acuity, fluorescein fundus angiography （FFA） and macular coherence tomography （OCT） were observed at 1 and 3 months after injection, and the changes of visual acuity and macular edema were analyzed. ResultsAll patients were followed up for 1-18 months. The visual acuity improved in 31 eyes（34.4%） after photocoagulation, no changed in 55 eyes （61.1%）, and decreased in 4 eyes （4.4%）. Macular edema disappeared in 11 eyes（12.2%）, macular edema was significantly reduced in 31 eyes（34.4%）, macular edema reducde in 32 eyes（35.5%）. No change in macular edema in 10 eyes（11.1%）, macular edema was aggravated in 6 eyes（6.7%）. ConclusionPosterior sub-tenon’s injection of triamcinolone acetonide can reduce the retinal edema, and the energy required for RP. It also can protect the function of the retina by reducing the complications.