球后注射曲安奈德治疗视网膜分支静脉阻塞继发黄斑水肿.docVIP

球后注射曲安奈德治疗视网膜分支静脉阻塞继发黄斑水肿 作者：高云霞，刘方毅，赵军，王赟，王强 【摘要】 　　目的 评价球后注射曲安奈德(triamcinolone acetonide,TA)治疗视网膜分支静脉阻塞（branch retinal vein occlusion,BRVO）继发黄斑水肿的有效安全性。方法 对27 例（31 眼）RVO 继发的严重黄斑水肿患者，患眼行球后注射曲安奈德　40mg/1ml，观察治疗前和治疗后1月、3月、6月时患者的最佳矫正视力、眼压、眼内炎性反应、晶体、眼底改变，光学相干断层扫描（optical　coherent　tomography，OCT）测定黄斑区视网膜厚度变化，FFA检查眼底荧光造影改变。结果 所有31眼中，有 25眼（80.64%）视力提高，4眼(12.9%)视力不变，2眼复发行玻璃体腔内注射TA 。视力治疗前为0.11±0.19,治疗后1月、3月、6月时分别为：0.36±0.32；0.56±0.28；0.65±0.35。黄斑中心凹平均厚度治疗前为582±139μm，治疗后1月、3月、6月时分别为：329±119μm；207±58μm；175±36μm。治疗前后比较差异有统计学意义（Ｐ＜0.05）。31眼中注射后1、3、6月分别有3眼(9.6%)、7眼(22.5%)和2眼(6.4%)眼压增高，经局部药物短期治疗后恢复正常。所有患眼未出现球后出血、眼内炎、白内障、视网膜脱离等并发症。结论 球后注射曲安奈德可安全有效地治疗 BRVO 继发的黄斑水肿。 【关键词】 视网膜分支静脉阻塞 曲安奈德 黄斑水肿 治疗 　　ABSTRACT Objective To evaluate the safe effect of retrobulbar injection of triaminolone acetonide (TA) in treating macular edema secondary to branch retinal vein occlusion (BRVO).Methods 31 affected eyes of 27 cases with serious macular edema secondary to BRVO received retroblbar injection of TA,40 mg/1 ml;the best corrected vision,introaocular pressure,inflammatory reaction,crystal and fundus changes of the patients before treatment and at the intervals of 1 month,3 months and 6 months after treatment were observed;optical coherent tomography (OCT) was applied to detect the changes of macular retinal thickness,and fundus fluorescein angiography was made as well.Results Out of the 31 eyes,25 eyes (80.64%) had vision improvement while the visions of 4 eyes remained the same,intravitreal injection of TA was performed to 2 cases with reoccurrence;the average vision before treatment was 0.11±0.19 and that in the 1st,the 3rd and the 6th month after treatment was 0.36±0.32,0.56±0.28 and 0.65±0.35 respectively;the average thickness of macular central fovea before treatment was 582±139 μm and that in the 1st,the 3rd and the 6th month after treatment was 329±119 μm,207±58 μm and 175±36 μm respectively;the difference was of statistical significance (Ｐ＜0.05);the introao