中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2009年
9期
980-984
,共5页
糖尿病性黄斑水肿%曲氨奈德%后Tenon囊%玻璃体腔
糖尿病性黃斑水腫%麯氨奈德%後Tenon囊%玻璃體腔
당뇨병성황반수종%곡안내덕%후Tenon낭%파리체강
Diabetic maeular edema%Triarncinolone acetonide%Posterior subtenon%Intravitreal injection
目的 观察后Tenon囊下注射TA治疗格栅样光凝失败的弥漫性DME的有效性和安全性.方法 选择因患弥漫性DME并已行格栅样光凝无效的患者(时间至少3个月以上)39例(42只眼).随机分二组,一组给予后Tenon囊下注射TA(posterior subtenon TA,PSTT)20mg/0.5ml;另外一组给予玻璃体腔内注射TA(intravitreal TA,IVTA)4mg/0.1ml,分别于治疗前、治疗后1、2和3月进行最佳矫正视力、OCT、眼压等检查,同时观察治疗后并发症,对结果进行统计分析,评价两种给药方式的临床疗效及安全性.结果 PSTT组和IVTA组治疗后1、2和3月的最佳矫正视力(best-corrected visual acuity,BCVA)均提高,与治疗前视力相比差异具有统计学意义(P<0.01).两种注射方法之间在治疗前和治疗后各不同时间点,BCVA变化无统计学差异(P>0.05).PSTT组和IVTA组治疗后1月、2月和3月黄斑中心凹厚度与治疗前相比明显减低,差异具有统计学意义(P<0.01).两种注射方法之间在治疗前和治疗后各不同时间点,黄斑中心凹厚度差别无统计学差异(P>0.05).PSTT组治疗后眼压升高3例,占13.6%;IVTA组治疗后眼压升高6例,占30%,假性眼内炎1例.结论 后Tenon囊下注射TA和玻璃体腔内注射TA对于格栅样光凝失败的弥漫性DME患者,都能在短期内不同程度地提高患者中心视力,有效降低黄斑区视网膜水肿.虽然玻璃体腔注射给药方式效果更为明显,但后Tenon囊下注射仍不失为一种安全、有效的给药途径.
目的 觀察後Tenon囊下註射TA治療格柵樣光凝失敗的瀰漫性DME的有效性和安全性.方法 選擇因患瀰漫性DME併已行格柵樣光凝無效的患者(時間至少3箇月以上)39例(42隻眼).隨機分二組,一組給予後Tenon囊下註射TA(posterior subtenon TA,PSTT)20mg/0.5ml;另外一組給予玻璃體腔內註射TA(intravitreal TA,IVTA)4mg/0.1ml,分彆于治療前、治療後1、2和3月進行最佳矯正視力、OCT、眼壓等檢查,同時觀察治療後併髮癥,對結果進行統計分析,評價兩種給藥方式的臨床療效及安全性.結果 PSTT組和IVTA組治療後1、2和3月的最佳矯正視力(best-corrected visual acuity,BCVA)均提高,與治療前視力相比差異具有統計學意義(P<0.01).兩種註射方法之間在治療前和治療後各不同時間點,BCVA變化無統計學差異(P>0.05).PSTT組和IVTA組治療後1月、2月和3月黃斑中心凹厚度與治療前相比明顯減低,差異具有統計學意義(P<0.01).兩種註射方法之間在治療前和治療後各不同時間點,黃斑中心凹厚度差彆無統計學差異(P>0.05).PSTT組治療後眼壓升高3例,佔13.6%;IVTA組治療後眼壓升高6例,佔30%,假性眼內炎1例.結論 後Tenon囊下註射TA和玻璃體腔內註射TA對于格柵樣光凝失敗的瀰漫性DME患者,都能在短期內不同程度地提高患者中心視力,有效降低黃斑區視網膜水腫.雖然玻璃體腔註射給藥方式效果更為明顯,但後Tenon囊下註射仍不失為一種安全、有效的給藥途徑.
목적 관찰후Tenon낭하주사TA치료격책양광응실패적미만성DME적유효성화안전성.방법 선택인환미만성DME병이행격책양광응무효적환자(시간지소3개월이상)39례(42지안).수궤분이조,일조급여후Tenon낭하주사TA(posterior subtenon TA,PSTT)20mg/0.5ml;령외일조급여파리체강내주사TA(intravitreal TA,IVTA)4mg/0.1ml,분별우치료전、치료후1、2화3월진행최가교정시력、OCT、안압등검사,동시관찰치료후병발증,대결과진행통계분석,평개량충급약방식적림상료효급안전성.결과 PSTT조화IVTA조치료후1、2화3월적최가교정시력(best-corrected visual acuity,BCVA)균제고,여치료전시력상비차이구유통계학의의(P<0.01).량충주사방법지간재치료전화치료후각불동시간점,BCVA변화무통계학차이(P>0.05).PSTT조화IVTA조치료후1월、2월화3월황반중심요후도여치료전상비명현감저,차이구유통계학의의(P<0.01).량충주사방법지간재치료전화치료후각불동시간점,황반중심요후도차별무통계학차이(P>0.05).PSTT조치료후안압승고3례,점13.6%;IVTA조치료후안압승고6례,점30%,가성안내염1례.결론 후Tenon낭하주사TA화파리체강내주사TA대우격책양광응실패적미만성DME환자,도능재단기내불동정도지제고환자중심시력,유효강저황반구시망막수종.수연파리체강주사급약방식효과경위명현,단후Tenon낭하주사잉불실위일충안전、유효적급약도경.
Objective To evaluate the effectiveness and safety of posterior subtenon injection (PSTT) in DME refratory to conventional grid laser photocoagnlation. Methods Thirty-nine cases (42 eyes) with clinical significant DME refratory to grid laser phtotcoagulation were assessed for the inclusion in the study and randomly divided into 2 groups. The PSTT group received 20mg/0.5ml TA and the IVTA group received 4mg/0.1ml TA injection. Complete ophthalmic examination with best-corrected visual acuity (BCVA), optic coherence tomography (OCT) and intraocular pressure (IOP) were performed before and in the 1st, 2nd, and 3rd months of the treatment. Results The BCVA during the treatment in both PSTT group and IVE group was significant increased compared to that ofprctreatment (P<0.01). The mean central foveal thickness during the treatment in both PSTT group and IVE group was significant decreased compared to that of pretreatment (P<0.01). There was no significant difference with respect to the decrease in the central foveal thickness and increase in the visual acuity between the PSTT group and the IVTA group. Significant IOP increase was found in 13.6% of the PSTT group and in 30% of the IVTA group. There was one case of pseudomonas endophthalmitis in the IVTA group. Conclusions Both PSTT and IVTA injections caused a significant increase in visual acuity and a decrease in central foveal thickness, especially in the short term. Although the effect was more pronounced in the IVTA group, the PSTT injection also seemed to be a safe and effective technique for the treatment of DME.