中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2015年
10期
734-738
,共5页
刘新书%王敏%赵潺%高斐%张美芬
劉新書%王敏%趙潺%高斐%張美芬
류신서%왕민%조잔%고비%장미분
葡萄膜炎%黄斑水肿%曲安奈德%注射,眼内
葡萄膜炎%黃斑水腫%麯安奈德%註射,眼內
포도막염%황반수종%곡안내덕%주사,안내
Uveitis%Macular edema%Triamcinolone acetonide%Injections,intraocular
目的 观察结膜下注射曲安奈德治疗葡萄膜炎继发黄斑水肿(UME)的疗效及安全性.方法 回顾性系列病例研究.收集2009年7月至2014年6月于北京协和医院眼科门诊确诊为UME患者的临床资料,将接受结膜下注射曲安奈德治疗并规律随诊至少6个月的32例(37只眼)患者纳入观察.治疗前后黄斑中心凹视网膜厚度(CMT)、最佳矫正视力(BCVA)及治疗后眼压升高为主要观察指标.采用配对t检验进行统计学分析.结果 37只眼首次结膜下注射曲安奈德1个月后,24只眼(64.9％)黄斑水肿明显好转,20只眼(54.1％)视力提高.平均CMT[(392.4±232.3)μm]较注射前[(498.9±211.9)μm]降低(t=-4.070,P＜0.01),平均BCVA(log MAR,0.33±0.30)较注射前(logMAR,0.45±0.29)提高(t=-4.835,P＜0.01),差异有统计学意义.3个月内,23只眼因明显好转未加用其他药物治疗,注射后3个月CMT及BCVA较注射后1个月改变无统计学意义.6个月内,23只眼中7只眼(30.4％)复发,再次注射有效.首次注射后9只眼眼压升高,再次注射后3只眼眼压升高,均可用局部降眼压药物或曲安奈德取出术控制.结论 结膜下注射曲安奈德可作为葡萄膜炎继发黄斑水肿的治疗方法之一,可明显减轻黄斑水肿,改善视力.其主要副作用是引起眼压升高,但可以通过局部使用降眼压药物或行曲安奈德取出术加以控制.
目的 觀察結膜下註射麯安奈德治療葡萄膜炎繼髮黃斑水腫(UME)的療效及安全性.方法 迴顧性繫列病例研究.收集2009年7月至2014年6月于北京協和醫院眼科門診確診為UME患者的臨床資料,將接受結膜下註射麯安奈德治療併規律隨診至少6箇月的32例(37隻眼)患者納入觀察.治療前後黃斑中心凹視網膜厚度(CMT)、最佳矯正視力(BCVA)及治療後眼壓升高為主要觀察指標.採用配對t檢驗進行統計學分析.結果 37隻眼首次結膜下註射麯安奈德1箇月後,24隻眼(64.9％)黃斑水腫明顯好轉,20隻眼(54.1％)視力提高.平均CMT[(392.4±232.3)μm]較註射前[(498.9±211.9)μm]降低(t=-4.070,P＜0.01),平均BCVA(log MAR,0.33±0.30)較註射前(logMAR,0.45±0.29)提高(t=-4.835,P＜0.01),差異有統計學意義.3箇月內,23隻眼因明顯好轉未加用其他藥物治療,註射後3箇月CMT及BCVA較註射後1箇月改變無統計學意義.6箇月內,23隻眼中7隻眼(30.4％)複髮,再次註射有效.首次註射後9隻眼眼壓升高,再次註射後3隻眼眼壓升高,均可用跼部降眼壓藥物或麯安奈德取齣術控製.結論 結膜下註射麯安奈德可作為葡萄膜炎繼髮黃斑水腫的治療方法之一,可明顯減輕黃斑水腫,改善視力.其主要副作用是引起眼壓升高,但可以通過跼部使用降眼壓藥物或行麯安奈德取齣術加以控製.
목적 관찰결막하주사곡안내덕치료포도막염계발황반수종(UME)적료효급안전성.방법 회고성계렬병례연구.수집2009년7월지2014년6월우북경협화의원안과문진학진위UME환자적림상자료,장접수결막하주사곡안내덕치료병규률수진지소6개월적32례(37지안)환자납입관찰.치료전후황반중심요시망막후도(CMT)、최가교정시력(BCVA)급치료후안압승고위주요관찰지표.채용배대t검험진행통계학분석.결과 37지안수차결막하주사곡안내덕1개월후,24지안(64.9％)황반수종명현호전,20지안(54.1％)시력제고.평균CMT[(392.4±232.3)μm]교주사전[(498.9±211.9)μm]강저(t=-4.070,P＜0.01),평균BCVA(log MAR,0.33±0.30)교주사전(logMAR,0.45±0.29)제고(t=-4.835,P＜0.01),차이유통계학의의.3개월내,23지안인명현호전미가용기타약물치료,주사후3개월CMT급BCVA교주사후1개월개변무통계학의의.6개월내,23지안중7지안(30.4％)복발,재차주사유효.수차주사후9지안안압승고,재차주사후3지안안압승고,균가용국부강안압약물혹곡안내덕취출술공제.결론 결막하주사곡안내덕가작위포도막염계발황반수종적치료방법지일,가명현감경황반수종,개선시력.기주요부작용시인기안압승고,단가이통과국부사용강안압약물혹행곡안내덕취출술가이공제.
Objective To observe the efficacy and safety of subconjunctival triamcinolone acetonide injections in the treatment of uveitic macular edema (UME).Methods A retrospective case series study.The clinical data of uveitis patients with macular edema were collected and analyzed at Peking Union Medical College Hospital from July 2009 to June 2014 with a minimum follow-up period of 6 months.The main outcome was central macular thickness (CMT) measured by optical coherence tomography at the 1st and the 3rd month after injection.The secondary outcomes included best corrected visual acuity (BCVA) at the 1st and the 3rd month, recurrence rate and intraocular pressure (IOP) within 6 months after injection.Results Thirty two patients (37 eyes) were included in the study.At the 1st month after the first injection, 24 of the 37 eyes (64.9％) showed an obvious reduction of CMT (at least 20％), among them 15 eyes (40.5％) showed a total resolution.The mean C MT decreased from (498.9±211.9)μm at baseline to (392.4±232.3) μm (t=-4.070, P＜0.01).The BCVA improved in 20 eyes (54.1％) and 15 eyes (40.5％) gained more than 0.2 log MAR unit.The mean BCVA increased from logMAR, 0.45±0.29 at baseline to logMAR, 0.33±0.30 (t=-4.835, P＜0.01).No statistically significant difference was found in mean CMT or BCVA in 23 eyes between the 1st and the 3rd month after injection.These eyes didn't receive any additional medications for improvement of the condition.Seven eyes (30.4％, 7/23) got a second injection because of relapse within 6 months after the first injection and the efficacy was good.The elevation of IOP over 21 mmHg(1 mmHg=0.133 kPa) were observed in 9 eyes and 3 eyes after the first and the second injection respectively.All of them were well controlled by either topical IOP lowering drugs or removal of the subconjunctival TA deposition.Conclusion Subconjunctival injection of triamcinolone acetonide is an effective and safe method for uveitic macular edema.
