摘要
目的评价玻璃体内注射曲安奈德(triamcinolone acetonide,TA)联合黄斑部格栅样光凝治疗弥漫性糖尿病性黄斑水肿(diabetic macular edema,DME)短期的临床疗效和安全性。方法将35例(39眼)弥漫性DME患者根据治疗方法不同分为2组,分别为单纯TA治疗组(24眼)和联合治疗组(TA注射联合黄斑部格栅样光凝术,15眼)。其中联合治疗组在TA注射1个月后行黄斑部格栅样光凝术,距TA注射术后3个月、6个月分别观察2组患者最佳矫正视力、眼压、裂隙灯显微镜、彩色眼底照相、OCT及并发症情况。结果治疗后3个月,单纯TA治疗组和联合治疗组最佳矫正视力分别为0.16±0.08、0.16±0.17,黄斑中心凹视网膜厚度分别为(272.2±59.4)μm、(279.0±98.9)μm,眼压分别为(15.4±4.3)mm Hg(1 k Pa=7.5 mm Hg)、(14.9±3.2)mm Hg,2组间最佳矫正视力、黄斑中心凹视网膜厚度和眼压比较差异均无统计学意义(均为P>0.05);治疗后6个月,单纯TA治疗组和联合治疗组最佳矫正视力分别为0.27±0.03、0.28±0.15,黄斑中心凹视网膜厚度分别为(289.2±33.9)μm、(248.0±102.7)μm,眼压分别为(15.5±2.3)mm Hg、(15.1±3.5)mm Hg,2组间最佳矫正视力、黄斑中心凹视网膜厚度和眼压比较差异亦均无统计学意义(均为P>0.05)。与治疗前视力相比,两组在治疗后3个月、6个月均有所提高,与治疗前黄斑中心凹视网膜厚度相比,两组均有所下降,与治疗前眼压相比,两组无明显变化。结论与单纯TA注射相比,玻璃体内注射TA联合黄斑部格栅样光凝治疗弥漫性DME短期内疗效和安全性并不占据明显优势。鉴于本次病例观察时间较短,尤其再次治疗的患者例数较少,故其远期疗效、安全性仍有待大样本的长期观察。
Objective To evaluate the efficacy and safety of intravitreal triamcinolone acetonide （TA） injection combined with macular grid photocoagulation for diffuse diabetic macular edema （DME）. Methods Thirty-five cases （39 eyes） with diffuse DME were randomly divided into TA injection group （24 eyes） and combined treatment group （ intravitreal injection of TA combined with macular grid photocoagulation, 15 eyes）. The combined treatment group underwent macular grid section photocoagulation surgery after 1 month of TA injection, the best corrected visual acuity, intraocular pressure （IOP）, slit lamp, color fundus photography, FFA and OCT and complications were observed at 3 months and 6 months after TA injection. Results The best corrected visual acuity at 3 months in TA injection group and combined treatment group were 0.16 ±0.08 and 0.16 ±0. 17 ,respectively;The foveal retinal thickness were （272.2 ±59.4） μm and （279.0 ±98.9） μm, respectively; The intraocuiar pressure were （ 15.4 ±4.3 ） mmHg （ 1 kPa = 7.5 mmHg） and （ 14.9± 3.2 ） mmHg, respectively; The differences in best corrected visual acuity, foveal retinal thickness and intraocuiar pressure was not statistically significant （ all P 〉 0.05 ）. The best corrected visual acuity at 5 months in TA injection group and combined treatment group were 0.27 ±0.03 and 0.28 ±0. 15, respectively;The foveal retinal thickness were （289.2 ±33.9） μm and （248.0 ± 102.7） μm,respectively ;The intraocular pressure were （ 15.5 ± 2.3 ） mmHg （ 15.1 ±3.5 ） mm- Hg, respectively;The differences in best corrected visual acuity, foveal retinal thickness and intraocular pressure was not statistically significant （ all P 〉 0.05 ）. Compared with pre-operation, the visual acuity at 3 months,6 months after treatment in the two groups improved;the foveal retinal thickness were decreased;the intraocular pressure had no obvious change. Conclusion Compared with the simple TA injection, the efficacy and safety of TA c
出处
《眼科新进展》
CAS
北大核心
2016年第11期1050-1053,共4页
Recent Advances in Ophthalmology
基金
佛山市医学重点专科培育项目(编号:Fspy1-2015005)~~
