三联法治疗黄斑水肿的疗效观察

Observation of Curative Effect on Triple Therapy of Macular Edema

目的对比观察玻璃体腔注射康柏西普或联合球后注射曲安奈德(TA)及格栅光凝治疗黄斑水肿的疗效。方法临床确诊黄斑水肿患者51例,其中糖尿病28例,视网膜静脉阻塞23例,随机分为A组17例(康柏西普玻璃体腔注射)、B组17例(康柏西普玻璃体腔注射+曲安奈德球后注射)和C组17例(康柏西普玻璃体腔注射+曲安奈德球后注射+格栅光凝)。3组治疗后1周以及1、3、6个月比较患眼最佳矫正视力(BCVA),黄斑中心凹视网膜厚度(CMT)及注药次数。结果与治疗前相比,3组治疗后各观察时间点BCVA、CMT均有明显改善(均P<0.05)。注射次数A组为(4.06±0.75)次、B组(3.24±0.97)次、C组(2.00±0.79)次,3组差异有统计学意义(P<0.05)。结论玻璃体腔注射康柏西普联合球后注射曲安奈德及黄斑格栅样光凝三联治疗黄斑水肿能有效促进水肿吸收,提高视力,并能减少康柏西普的注药次数,疗效更稳定持久。

Objective To compare the efficacy of intravitreal conbercept injection or combined triamcinolone acetonide retrobular injection with macular grid pattern photocoagulation in treating macular edema.Methods 51 eyes of 51 patients diagnosed as macular edema including 28 patients(28 eyes)with diabetic macular edema and 23 patients(23 eyes)with retinal vein occlusion were divided into conbercept(group A),conbercept combined triamcinolone acetonide(group B)and conbercept combined triamcinolone acetonide with macular grid pattern photocoagulation(group C),with 17 eyes in each group.The best corrected visual acuity(BCVA)and the central macular thickness(CMT)were compared in three groups after one week,one,three and six months of treatment.Results Compared with before treatment,both CMT and BCVA of each group had improved obviously in 1 week and 1,3,6 months,the difference before and after treatment had statistical significance(all P<0.05).Besides,the frequency of injection was(4.06±0.75)times in group A,(3.24±0.97)times in group B and(2.00±0.79)times in group C.Differences among the three groups had statistical significance(P<0.05).Conclusion The treatment of intravitreal conbercept injection or combined triamcinolone acetonide retrobular injection with macular grid pattern photocoagulation can reduce macular edema and improve eyesight.Combination therapy can reduce the frequency of injection.The curative effect is more stable and lasting.