摘要
目的 观察口服糖皮质激素联合降眼压药物对合并多灶性脉络膜炎(MFC)的病理性近视(PM)患者近视发展的影响。方法 合并MFC的PM患者56例(76眼),给予中等剂量糖皮质激素(醋酸泼尼松)口服治疗,平均疗程为13.5周;同时联合布林佐胺滴眼液滴眼24个月。于治疗后3、6、12、18及24个月进行随访,记录眼轴长度(AL)、等效球镜度(SE)、眼压、最佳矫正视力(BCVA)和视野平均敏感度(MS)。结果 治疗后患者眼底彩像可见病变区域面积较治疗前稍减小,FFA荧光素渗漏程度较治疗前好转。与治疗前比较,治疗后3个月AL、SE、眼压差异无统计学意义,治疗后24个月AL、SE差异亦无统计学意义。与治疗前、治疗后3个月比较,治疗后6、12及18个月各指标差异均有统计学意义(P<0.05);治疗后3、6、12和18个月时,各时点BCVA和视野MS比较差异均有统计学意义(P<0.05)。治疗后3、24个月,AL与眼压、SE均无相关性;治疗后6、12及18个月,AL与眼压呈正相关,与SE呈负相关(均P<0.01)。结论 口服糖皮质激素联合降眼压药物治疗合并MFC的PM,可控制PM眼轴和近视屈光度的增长,有效改善视功能。
Objective To observe the effect of oral glucocorticoid combined with ocular hypotensive drugs on the development of myopia in patients with pathologic myopia(PM) complicated with multifocal choroiditis(MFC).Methods A total of 56 PM patients(76 eyes) with MFC were collected,and they were treated with moderate-dose glucocorticoid(prednisone acetate) orally,with an average course of 13.5 weeks.At the same time,they were combined with brinzolamide eye drops for 24 months.Axial length(AL),spherical equivalent(SE),intraocular pressure,best corrected visual acuity(BCVA) and mean sensitivity of visual field(mean sensitivity,MS) were followed-up and recorded at 3 months,6 months,12months,18 months and 24 months.Results After treatment,the color image of the fundus showed that the lesion area was slightly smaller than that before treatment,and the leakage of FFA fluorescein was improved compared with that before treatment.Compared with before treatment,there were no significant differences in AL,SE and intraocular pressure only at 3 months after treatment,and there were no significant differences in AL and SE at 24 months after treatment.Compared with before treatment and 3 months after treatment,there were significant differences in each index at 6,12 and 18 months after treatment(P <0.05).There were significant differences in BCVA and visual field MS at different time points between 3,6and 24 months after treatment(P <0.05).At 3 and 24 months after treatment,there was no correlation between AL and intraocular pressure and SE.At 6,12 and 18 months after treatment,AL was positively correlated with intraocular pressure and negatively correlated with SE(P<0.01).Conclusion Oral glucocorticoid combined with ocular hypotensive drugs to treat PM with MFC can control the growth of PM AL and myopia diopter,and effectively improve visual function.
作者
肖博文
曹维
刘莉静
赵香
王昕
XIAO Bowen;CAO Wei;LIU Lijing;ZHAO Xiang;WANG Xin(Department of Ophthalmology,Tianjin Beichen Hospital,Nankai University Affiliated Beichen Hospital,Tianjin 300400,China)
出处
《天津医药》
CAS
北大核心
2023年第1期54-57,共4页
Tianjin Medical Journal
