口服羟苯磺酸钙联合玻璃体腔注射曲安奈德对全视网膜激光光凝后黄斑水肿的疗效及安全性分析

Effectiveness and safety of oral calcium dobesilate combined with intravitreal injection of triamcinolone acetonide on macular edema after panretinal laser photocoagulation

目的:探讨口服羟苯磺酸钙联合玻璃体腔注射曲安奈德对全视网膜激光光凝后黄斑水肿(ME)的临床疗效及安全性。方法:选取2015年3月至2016年3月首都医科大学宣武医院眼科收治的因严重糖尿病视网膜病变行全视网膜激光光凝后ME患者82例(共82眼),按照随机数字表法将其分为观察组和对照组,每组41例(41眼)。对照组予以玻璃体腔注射曲安奈德治疗,观察组在对照组的治疗基础上联合加用羟苯磺酸钙胶囊口服治疗。比较两组术前、术后1个月、3个月、6个月最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)、眼压(IOP)以及不良反应发生情况。结果:观察组术后1个月、3个月、6个月BCVA明显高于术前及对照组,CMT明显低于术前及对照组(均P<0.05)。两组术后1个月IOP明显高于术前(P<0.05),而术后3个月、6个月IOP与术前比较,差异无统计学意义(均P>0.05)。两组术后1个月、3个月、6个月IOP及不良反应总发生率比较,差异均无统计学意义(均P>0.05)。结论:口服羟苯磺酸钙联合玻璃体腔注射曲安奈德治疗全视网膜激光光凝后ME,可显著提高矫正视力,安全性好。

Objective:To evaluate the clinical efficacy and safety of oral calcium dobesilate combined with intravitreal injection of triamcinolone acetonide on macular edema after laser retinal photocoagulation. Methods:A total of 82 patients with macular edema (82 eyes) after total retinal laser photocoagulation were selected,and randomly divided into an observation group and a control group,with 41 cases in each group.The patients in the control group received intravitreal injections of triamcinolone acetonide,and those in the observation group were treated as the control group with addition of oral calcium dobesilate capsules.The best corrected visual acuity (BCVA),central macular thickness (CMT) and intraocular pressure (IOP) as well as the incidence of adverse reactions were compared. Results:The BCVA was higher in the observation group than that in the control group after 1,3 and 6 months of surgery,while the CMT was significantly lower ( P <0.05).The IOP of both groups were significantly increased after one month of surgery ( P <0.05).No significant differences in IOP at 1,3 and 6 months post-operation and the incidence of adverse reactions were found between the two groups ( P >0.05). Conclusion:Oral calcium dobesilate combined with intravitreal injection of triamcinolone acetonide could notably elevate the corrected visual acuity,improve macular edema after panretinal photocoagulation,and was safe.