临床眼科杂志
臨床眼科雜誌
림상안과잡지
JOURNAL OF CLINICAL OPHTHALMOLOGY
2014年
5期
410-412
,共3页
曲安奈德%黄斑水肿%糖尿病视网膜病变
麯安奈德%黃斑水腫%糖尿病視網膜病變
곡안내덕%황반수종%당뇨병시망막병변
Triamcinolone acetonide%Macular edema%Diabetic retinopathy
目的:评价玻璃体内注射曲安奈德( TA)治疗糖尿病性黄斑水肿的疗效与安全性。方法回顾性分析自2011年12月至2013年3月在我院眼科确诊的68例(84只眼)糖尿病性视网膜病变黄斑水肿患者,行玻璃体腔内注射TA(40 mg/l)0.1 ml,随访3~15个月,平均8.9个月,观察BCVA、眼压、晶状体、炎症反应,OCT检测黄斑中心凹视网膜厚度,FFA检查观察黄斑部毛细血管渗漏情况。结果68例(84只眼)患者治疗后视力均有不同程度提高,黄斑水肿减轻。治疗后1、2、3个月平均视力分别为0.39±0.17、0.47±0.20、0.37±0.18,与治疗前平均视力0.19±0.13比较,差异有统计学意义( t值分别为4.482、5.733、4.051, P﹤0.05)。黄斑中心凹视网膜平均厚度分别为(198.12±28.94)μm、(183.66±24.66)μm、(225.96±50.90)μm,与治疗前平均视力(596.35±127.37)μm比较,差异有统计学意义( t值分别为15.253、15.934、13.227, P﹤0.05)。 FFA检查显示治疗后荧光渗漏明显减少。9例(9只眼)眼压≥21 mm Hg,其中1例(1只眼)为34.2 mm Hg。5例(7只眼)4~7个月后黄斑水肿复发。2例(2只眼)8个月、12个月后晶状体后囊混浊明显。无感染发生。结论玻璃体腔内注射TA能有效改善糖尿病性黄斑水肿,提高视力,但部分患眼出现黄斑水肿复发、眼压升高,部分出现晶状体混浊加重。
目的:評價玻璃體內註射麯安奈德( TA)治療糖尿病性黃斑水腫的療效與安全性。方法迴顧性分析自2011年12月至2013年3月在我院眼科確診的68例(84隻眼)糖尿病性視網膜病變黃斑水腫患者,行玻璃體腔內註射TA(40 mg/l)0.1 ml,隨訪3~15箇月,平均8.9箇月,觀察BCVA、眼壓、晶狀體、炎癥反應,OCT檢測黃斑中心凹視網膜厚度,FFA檢查觀察黃斑部毛細血管滲漏情況。結果68例(84隻眼)患者治療後視力均有不同程度提高,黃斑水腫減輕。治療後1、2、3箇月平均視力分彆為0.39±0.17、0.47±0.20、0.37±0.18,與治療前平均視力0.19±0.13比較,差異有統計學意義( t值分彆為4.482、5.733、4.051, P﹤0.05)。黃斑中心凹視網膜平均厚度分彆為(198.12±28.94)μm、(183.66±24.66)μm、(225.96±50.90)μm,與治療前平均視力(596.35±127.37)μm比較,差異有統計學意義( t值分彆為15.253、15.934、13.227, P﹤0.05)。 FFA檢查顯示治療後熒光滲漏明顯減少。9例(9隻眼)眼壓≥21 mm Hg,其中1例(1隻眼)為34.2 mm Hg。5例(7隻眼)4~7箇月後黃斑水腫複髮。2例(2隻眼)8箇月、12箇月後晶狀體後囊混濁明顯。無感染髮生。結論玻璃體腔內註射TA能有效改善糖尿病性黃斑水腫,提高視力,但部分患眼齣現黃斑水腫複髮、眼壓升高,部分齣現晶狀體混濁加重。
목적:평개파리체내주사곡안내덕( TA)치료당뇨병성황반수종적료효여안전성。방법회고성분석자2011년12월지2013년3월재아원안과학진적68례(84지안)당뇨병성시망막병변황반수종환자,행파리체강내주사TA(40 mg/l)0.1 ml,수방3~15개월,평균8.9개월,관찰BCVA、안압、정상체、염증반응,OCT검측황반중심요시망막후도,FFA검사관찰황반부모세혈관삼루정황。결과68례(84지안)환자치료후시력균유불동정도제고,황반수종감경。치료후1、2、3개월평균시력분별위0.39±0.17、0.47±0.20、0.37±0.18,여치료전평균시력0.19±0.13비교,차이유통계학의의( t치분별위4.482、5.733、4.051, P﹤0.05)。황반중심요시망막평균후도분별위(198.12±28.94)μm、(183.66±24.66)μm、(225.96±50.90)μm,여치료전평균시력(596.35±127.37)μm비교,차이유통계학의의( t치분별위15.253、15.934、13.227, P﹤0.05)。 FFA검사현시치료후형광삼루명현감소。9례(9지안)안압≥21 mm Hg,기중1례(1지안)위34.2 mm Hg。5례(7지안)4~7개월후황반수종복발。2례(2지안)8개월、12개월후정상체후낭혼탁명현。무감염발생。결론파리체강내주사TA능유효개선당뇨병성황반수종,제고시력,단부분환안출현황반수종복발、안압승고,부분출현정상체혼탁가중。
Objective To evaluate the efficacy and safety of triamcinolone acetonide ( TA) intravitreous injection for the treatment of macular edema due to diabetic retinopathy .Methods A total of 68 patients (84 eyes) diagnosed with macular edema due to diabetic retinopathy were enrolled in this study between December 2011 and March 2013.Patients received intravitreous injection of TA (40 mg/l) 0.1 mL and were followed-up for 3 to 15 months, with the average follow-up period being 8.9 months.Best-corrected visual acuity, intraocular pressure, lens and fundus were closely observed . Retinal thickness was examined with OCT , and vascular leakage was detected with FFA .Results Macular edema reduced and visual acuity improved in 68 patients (84 eyes).Mean vision acuity was 0.39 ±0.17, 0.47 ±0.20 and 0.37 ±0.18 at 1, 2, and 3 months, respectively, after the treatment.Comparing with the pre-treatment visual acuity (0.19 ±0.13), the improvement was statistically significant ( t =4.48, 5.73, and 4.05;P <0.05).Baseline macular thickness was 596.35 ±127.37 μm before the treatment, and it reduced to 198.12 ±28.94 μm, 183.66 ±24.66 μm, and 225.96 ± 50.90 μm after the treatment ( t =15.3, 15.9, 13.23, P <0.05).FFA showed minimal fluorescein leakage .Nine pa-tients (9 eyes) had the IOP ≥21 mm Hg, with the highest being 34.2 m mHg in one eye.Recurrence of macular edema was found in 7 eyes (5 patients) at 4 to 7 months.At 8 and 12 months, posterior subcapsular cataract was found in 2 eyes (2 patients).There was no infection.Conclusion Intravitreous injection with TA may be effective in reducing macular e-dema and improving visual acuity , but recurrence of macular edema , increased intraocular pressure , or posterior subcapsu-lar cataract could occur to some patients .