摘要
目的观察曲安奈德（TA）球筋膜下（Tenon囊）注射联合全身糖皮质激素治疗Vogt-小柳-原田氏病（VKH）的浆液性视网膜脱离的效果。方法于2010年5月至2011年10月在眼科门诊就诊的Vogt—小柳-原田病患者23例46只眼，随机分为两组，对照组（22只眼）单纯给予糖皮质激素治疗；观察组（24只眼）糖皮质激素联合曲安奈德球筋膜下注射治疗。两组患者分别在治疗前及治疗后1周、1个月、3个月、6个月常规检查裸眼视力、最佳矫正视力、眼前节检查、眼底荧光血管造影（FFA）和光学相干断层扫描（OCT）检查，并对数据进行分析。结果治疗后不同时期，观察组视力提高水平均较对照组高；治疗3个月后两组患者荧光血管造影图像的比较，观察组有效率（91．6％）高于对照组（63．6％），差异有统计学意义（x2=5．3008，P=0．021）。治疗后黄斑区视网膜神经上皮层的厚度，观察组为（151±53）μm，对照组为（283±67）μm，两组差别有统计学意义（P=0．000）。患者视力和视网膜神经上皮层厚度进行相关性分析（r=-0．897，P=0．000）；视力水平和神经上皮层厚度呈显著负相关。结论全身大剂量糖皮质激素联合曲安奈德球筋膜下注射可以促进黄斑区视网膜下积液迅速吸收，恢复视功能，缩短治疗时间。
Objective To observe the clinic effect of Vogt-Koyanagi-Harada （VKH） disease by injecting triamcinolone acetonide （TA） under Tenon＇ s. Methods Forty-six eyes of 23 consecutive patients diagnosed with diagnosed with acute VKH disease in our department of ophthalmology from May 2010 to October 2011. All the patients were divided into 2 groups： control group （22 eyes） were given pmethylprednisolone and observed group （24 eyes） were given pmethylprednisolone com- bined with TA injection under Tenon＇ s. All the patients were performed no-corrected visual activity, best corrected visual activity, slitlamp check, fundus photograph and spectral-domain optical coherence tomography （OCT） at the initial visit and 1 week, 1 month, 3 months, and 6 months after steroid treatment. All the data were analyzed by SPSS 13.0. Results After the treatment, the VA improved levels was higher in observed group than in control group. After treatment 3 months, the FFA of VKH disease showed the effective was higher in observed group （91.6%） than in control group （63.6%）, there was significantly difference between the two groups （g2=5.3008, P =0.021）. The thickness of fovea was （151±53）μm in observed group and （283±67）μm in control group, there was significantly difference between the two groups （P =000）. There was statistically significant correlation between the vision activity with the thickness of serous retinal detachment （r =-0.897, P = 0.000）. Conclusions The patients with VHK disease treated by pmethylprednisolone combined with TA injection under Tenon＇s can enhance the clinic effect and reduce the treatment time.
出处
《中国实用眼科杂志》
CSCD
北大核心
2013年第5期575-577,共3页
Chinese Journal of Practical Ophthalmology
