球后注射曲安奈德联合激光治疗对糖尿病黄斑水肿患者视功能的影响

Effect of retrobulbar injection of triamcinolone acetonide on visual function in patients with diabetic macular edema

目的分析玻璃体腔与球后注射曲安奈德联合激光治疗应用于糖尿病黄斑水肿(DME)患者中的临床效果。方法掷币法将在我院入院治疗的85例DME患者分为IVTA组与RBTA组,其中IVTA组42例予玻璃体腔注射曲安奈德(IVTA)联合激光治疗,RBTA组43例予球后注射曲安奈德(RBTA)联合激光治疗。对比两组治疗后1、3、6个月的最佳矫正视力(BCVA)和黄斑厚度(CMT)变化情况。结果两组患者治疗后1、3、6个月的BCVA水平高于治疗前,(P<0.05),其中IVTA组由0.26±0.11提高到0.46±0.06、 0.67±0.21、 0.93±0.11,RBTA组由0.25±0.10提高到0.43±0.14、0.64±0.07、0.90±0.05;两组患者治疗后1、3、6个月的黄斑厚度低于治疗前,(P<0.05),其中IVTA组由826.71±26.13降低到765.02±20.71、 507.33±18.08、 360.15±19.64,RBTA组由817.55±18.44降低到759.69±15.06、514.67±20.41、352.88±14.63;RBTA组的并发症发生率低于IVTA组,(P<0.05)。结论 IVTA、RBTA联合光凝均可提高患者视力水平,减轻黄斑水肿状态,但RBTA方式所造成的并发症少。

Objective To analyze the clinical effect of intravitreal and retrobulbar injection of triamcinolone acetonide in the treatment of diabetic macular edema (DME). Methods 85 cases of DME patients admitted to our hospital were divided into IVTA group and RBTA group. Among them, 42 cases in IVTA group received intravitreal injection of triamcinolone acetonide (IVTA) combined with laser treatment, and 43 cases in RBTA group received post-ball injection of Triamcinolone acetonide (RBTA) combined with laser treatment. The best corrected visual acuity (BCVA) and macular thickness (CMT) changes were compared between the two groups at 1, 3, and 6 months after treatment. Results The BCVA levels in the first, third and sixth months after treatment were higher than those before treatment (P<0.05), and the IVTA group increased from 0.26±0.11 to 0.46±0.06, 0.67±0.21, 0.93±0.11, RBTA group. From 0.25±0.10 to 0.43±0.14, 0.64±0.07, 0.90±0.05;the thickness of macular at 1, 3, and 6 months after treatment was lower than that before treatment (P<0.05), and the IVTA group was 826.71± 26.13 decreased to 765.02±20.71, 507.33±18.08, 360.15±19.64, and the RBTA group decreased from 817.55±18.44 to 759.69±15.06, 514.67±20.41, 352.88±14.63;the complication rate of RBTA group was lower than that of IVTA group (P< 0.05). Conclusion Both IVTA and RBTA combined with photocoagulation can improve the visual acuity of patients and reduce the degree of macular edema, but the complications caused by RBTA method are few.