结膜下注射曲安奈德治疗葡萄膜炎继发黄斑水肿32例

Efficacy of Subconjunctival Injection of Triamcinolone Acetonide in the Treatment of 32 Cases of Uveitis Macular Edema

目的观察曲安奈德结膜下注射治疗葡萄膜炎继发黄斑水肿(uveitis macular edema,UME)的临床疗效。方法对2018年1月至2021年12月在南昌市新建区人民医院眼科的UME患者32例(39只眼)给予曲安奈德结膜下注射治疗。结果25只UME患眼在首次曲安奈德结膜下注射0.2 mL后1个月明显好转,12只UME患眼痊愈;首次注射后3个月内黄斑中心凹视网膜厚度(CMT)下降不明显,最佳矫正视力(BCVA)略提高;再次注射后的6个月内,患眼黄斑水肿100%好转,注射曲安奈德前后CMT与BCVA对比差异有统计学意义(P<0.05)。结论曲安奈德结膜下注射治疗UME,操作简单、可行性好、安全性高,CMT减少明显,患者视力得到提高;对UME给予局部糖皮质激素治疗是值得推广的给药途径之一。

Objective To observe the clinical efficacy of subconjunctival injection of triamcinolone acetonide in the treatment of uveitis macular edema(UME).Methods Patients with UME in the ophthalmology department of the Xinjian District People's Hospital,Nanchang,China,from January 2018 to December 2021 were given subconjunctival injections of triamcinolone acetonide.Results 25 of the UME eyes significantly improved one month after the first subconjunctival injection of 0.2 mL triamcinolone acetonide,and 12 of the UME eyes recovered.Within 3 months after the first injection,there was a nonsignificant decrease in the central macular thickness(CMT)and a slight increase in the best corrected visual acuity(BCVA).Of the UME eyes receiving a second injection,100%showed improvement in macular edema within six months.Statistical significance was found in the comparison of CMT and BCVA before and after triamcinolone acetonide injection(P<0.05).Conclusion Subconjunctival injection of triamcinolone acetonide is a simple procedure that can significantly reduce CMT,and the topical glucocorticoid therapy is a route of administration that deserves wider application in the treatment for uveitis macular edema in clinical practice.