CAJ | 학술논문

目的评价玻璃体腔内注射曲安奈德(TA)联合全视网膜光凝(PRP)治疗糖尿病性黄斑水肿的效果.方法将诊断为糖尿病性黄斑水肿的31例患者31只患眼,随机分为PRP治疗组(对照组)16例16只眼和IVTA联合PRP治疗组(联合组)15例15只眼,治疗后1月、3月、6月分别检查并记录患者的最佳矫正视力(BCVA)、眼压(IOP)、眼底荧光血管造影(FFA)、光学相干断层扫描(OCT)、眼前节及眼底情况等,相关数据应用SPSS进行t-检验、直接概率计算法、重复设计的方差分析.结果 (1)联合组PRP治疗后3个月、6个月BCVA高于对照组(P＜0.05)；(2)联合组PRP治疗后1个月、3个月视网膜新生血管(RNV)渗漏面积小于对照组(P＜0.05),6个月后差异无统计学意义(P＞0.05)；(3)联合组PRP治疗后1个月、3个月、6个月黄斑中心区视网膜厚度(CMT)值低于对照组(P＜0.05)；(4)联合治疗组所需激光能量低于对照组(P＜0.01)；(5)两组IOP值差异无统计学意义(P＞0.05).结论玻璃体腔注射TA联合全视网膜光凝治疗糖尿病性黄斑水肿可以降低PRP所需能量,减少PRP对视网膜的损伤,减轻延缓水肿,提高视力,是一种值得推荐的糖尿病黄斑水肿的治疗方法.
목적 평개파리체강내주사곡안내덕(TA)연합전시망막광응(PRP)치료당뇨병성황반수종적효과.방법 장진단위당뇨병성황반수종적31례환자31지환안,수궤분위PRP치료조(대조조)16례16지안화IVTA연합PRP치료조(연합조)15례15지안,치료후1월、3월、6월분별검사병기록환자적최가교정시력(BCVA)、안압(IOP)、안저형광혈관조영(FFA)、광학상간단층소묘(OCT)、안전절급안저정황등,상관수거응용SPSS진행t-검험、직접개솔계산법、중복설계적방차분석.결과 (1)연합조PRP치료후3개월、6개월BCVA고우대조조(P＜0.05)；(2)연합조PRP치료후1개월、3개월시망막신생혈관(RNV)삼루면적소우대조조(P＜0.05),6개월후차이무통계학의의(P＞0.05)；(3)연합조PRP치료후1개월、3개월、6개월황반중심구시망막후도(CMT)치저우대조조(P＜0.05)；(4)연합치료조소수격광능량저우대조조(P＜0.01)；(5)량조IOP치차이무통계학의의(P＞0.05).결론 파리체강주사TA연합전시망막광응치료당뇨병성황반수종가이강저PRP소수능량,감소PRP대시망막적손상,감경연완수종,제고시력,시일충치득추천적당뇨병황반수종적치료방법.
Objective To evaluate the effect of intravitreal injection with triamcinolone acetonide (TA) combined with all Panretinal photocoagulation (PRP) in treating the diabetic macular edema.Methods Thirty-one patients with 31 eyes in diabetic macular edema were chosen.Patients were randomly divided into two groups,which were the PRP treatment group,and IVTA plus PRP group.The combined treatment group completed IVTA 4mg (0.1ml) in 7 days after PRP treatment,a total of 4 times per week,the PRP treatment group was only treated with PRP alone,a total of 4 times per week.All patients in the two groups were return visit,and checked the BCVA,IOP,FFA,OCT,anterior segment and fundus after 1 month,3 months,and 6 months.All the data used the statistical analysis methods by the SPSS data applications,including the t-test,the direct probability calculation,and repeated design analysis of variance. Results The average best corrected visual acuity in the combined treatment group were higher than the PRP treatment group 3 months and 6 months after treatment (P＜0.05).The RNV leakage area was significantly lower in the combined treatment group after treatment of 1 month and 3 months (P ＜0.05),but was not significant after 6 months (P＞0.05).The macular retinal thickness values lowered in the joint group after 1 month,3 months,6 months (P＜0.05).The combined treatment group required lower laser energy than the PRP treatment group (P＜0.01).The IOP in both groups were no different (P＞0.05). Conclusions Intravitreal injection of TA combined with all retinal photocoagulation is a good way in treat the diabetic macular edema,which can reduce the energy needed for PRP,reduce the delay edema,and improve vision,which is a worthy recommendation in treating the diabetic macular edema.