结膜下注射曲安奈德治疗葡萄膜炎继发黄斑水肿的疗效评价

Evaluation on curative effect of subconjunctival injection of triamcinolone acetonide in the treatment of uveitic macular edema

目的探讨葡萄膜炎继发黄斑水肿(UME)采取结膜下注射曲安奈德治疗的临床效果。方法 75例(90眼)葡萄膜炎继发黄斑水肿患者,随机分为对照组[38例(45眼)]及观察组[37例(45眼)]。对照组行球内注射曲安奈德;观察组采取结膜下注射曲安奈德。比较两组临床疗效,治疗前后最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(FRT),随访期间不良反应。结果观察组总有效率为95.56%(43/45),高于对照组的82.22%(37/45),差异具有统计学意义(χ~2=4.050,P=0.044<0.05)。治疗前,两组患者治疗前后BCVA与FRT比较,差异均无统计学意义(P>0.05);治疗后,两组患者的BCVA、FRT均较本组治疗前改善,且观察组改善幅度优于对照组,差异均具有统计学意义(P<0.01)。观察组随访3个月内不良反应发生率为33.33%,明显低于对照组的55.56%,差异具有统计学意义(χ~2=4.500,P=0.034<0.05)。结论葡萄膜炎继发黄斑水肿采取结膜下注射曲安奈德治疗更有助于减轻黄斑水肿,改善视力预后,疗效切实,安全可靠,具有较高临床参考价值。

Objective To explore the clinical effect of uveitic macular edema(UME)treated with subconjunctival injection of triamcinolone acetonide.Methods A total of75patients(90eyes)with uveitic macular edema were randomly divided into control group[38cases(45eyes)]and observation group[37cases(45eyes)].The control group received intravitreal injection of triamcinolone acetonide,and the observation group received subconjunctival injection of triamcinolone acetonide.Comparison were made on clinical curative effect,best corrected visual acuity(BCVA),foveal retinal thickness(FRT)before and after treatment,and adverse reactions during follow-up in two groups.Results The observation group had higher total effective rate as95.56%(43/45)than82.22%(37/45)in the control group,and the difference had statistical significance(χ2=4.050,P=0.044<0.05).Before treatment,both groups had no statistically significant difference in BCVA and FRT before and after treatment(P>0.05).After treatment,both groups had improved BCVA and FRT than before treatment,and the observation group had better improvement than the control group.Their difference had statistical significance(P<0.01).The observation group had obviously lower incidence of adverse reactions in3months of follow-up as33.33%than55.56%in the control group,and the difference had statistical significance(χ2=4.500,P=0.034<0.05).Conclusion For the treatment of uveitic macular edema,subconjunctival injection of triamcinolone acetonide can reduce macular edema,improve prognosis of visual acuity with affirmative curative effect,safety and reliability,and it has high clinical reference value.