玻璃体内注射曲安奈德治疗视网膜中央静脉阻塞所致黄斑囊样水肿

Effect of intravitreal triamcinolone acetonide in the treatment of cystoid macular edema caused by central retinal vein occlusion

目的分析玻璃体内注射曲安奈德治疗视网膜中央静脉阻塞(CRVO)引起的黄斑囊样水肿的效果。方法将2017年1月至2019年8月在西安航天总医院治疗的因CRVO导致的黄斑囊样水肿患者80例(共92眼)作为研究对象,应用随机数表法分为对照组(40例,45眼)和观察组(40例,47眼),对照组给予单纯视网膜光凝,观察组在对照组治疗基础上于玻璃体内注射曲安奈德治疗,比较两组患者治疗后12个月内的最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)和眼内压(IOP)变化情况。结果(1)BCVA:观察组和对照组患者治疗后1个月(55.60±4.22 vs 42.66±7.17)、3个月(66.62±4.35 vs 50.91±4.30)、6个月(62.39±4.83 vs 51.05±5.54)和12个月(58.52±5.08 vs 50.44±3.46)比较,观察组的BCVA明显优于对照组,差异均有统计学意义(P<0.05);(2)CMT:观察组与对照组患者治疗后1个月[(381.60±79.62)μm vs(652.74±90.55)μm]、3个月[(244.35±63.73)μm vs(469.17±82.36)μm]、6个月[(275.28±98.62)μm vs(488.36±74.32)μm]和12个月[(388±88.16)μm vs(513.95±101.27)μm]比较,观察组的CMT明显优于对照组,差异均有统计学意义(P<0.05);(3)IOP:观察组与对照组患者治疗后1个月[(1.75±0.30)kPa vs(1.85±0.28)kPa]、3个月[(1.73±0.26)kPa vs(1.83±0.26)kPa]、6个月[(1.72±0.26)kPa vs(1.81±0.24)kPa]和12个月[(1.72±0.20)kPa vs(1.80±0.22)kPa]比较,观察组的IOP明显优于对照组,差异均具有统计学意义(P<0.05)。结论在常规光凝治疗的基础上联合应用曲安奈德治疗能加速黄斑囊样水肿吸收,迅速提高患者视力。

Objective To analyze the effect of intravitreal triamcinolone acetonide in the treatment of cystoid macular edema caused by central retinal vein occlusion.Methods From January 2017 to August 2019,80 cases(92 eyes)of cystoid macular edema caused by central retinal vein occlusion in Xi'an Aerospace General Hospital were randomly divided into control group(40 cases,45 eyes,treated with retinal photocoagulation alone)and observation group(40 cases,47 eyes,treated with intravitreal triamcinolone acetonide on the basis of the treatment in the control group).The best corrected visual acuity(BCVA),macular fovea retinal thickness(CMT),and intraocular pressure(IOP)of the two groups were compared within 12 months after treatment.Results(1)BCVA in the observation group were significantly better than that in the control group at 1 month after treatment(55.60±4.22)vs(42.66±7.17);at 3 months after treatment(66.62±4.35)vs(50.91±4.30);at 6 months after treatment(62.39±4.83)vs(51.05±5.54);and at 12 months after treatment(58.52±5.08)vs(50.44±3.46),with statistically significant differences(P<0.05).(2)CMT in the observation group was significantly better that in the control group at 1 month after treatment(381.60±79.62)μm vs(652.74±90.55)μm;at 3 months after treatment(244.35±63.73)μm vs(469.17±82.36)μm;at 6 months after treatment(275.28±98.62)μm vs(488.36±74.32)μm;and at 12 months after treatment(388±88.16)μm vs(513.95±101.27)μm,with statistically significant difference(P<0.05).(3)IOP in the observation group was significantly better than that in the control group at 1 month after treatment(1.75±0.30)kPa vs(1.85±0.28)kPa;at 3 months after treatment(1.73±0.26)kPa vs(1.83±0.26)kPa;at 6 months after treatment(1.72±0.26)kPa vs(1.81±0.24)kPa;and at 12 months after treatment(1.72±0.20)kPa vs(1.80±0.22)kPa;the differences were statistically significant(P<0.05).Conclusion The combination of triamcinolone acetonide and conventional photocoagulation can accelerate the absorption of cystoid macular edema and improve the visual acuity of patients.