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论文.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论文 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.freel，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 acular 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 ography (OCT) acular retinal thickness,and fundus fluorescein angiography ade as provement ained the same,intravitreal injection of TA ed to 2 cases ent onth after treatment acular central fovea before treatment and that in the 1st,the 3rd and the 6th month after treatment ,207±58 μm and 175±36 μm respectively;the difference onth after the injection as onths after the injection and 2 eyes (6.4%) 6 months after the injection,they all became normal after local drug administration for a short time;no such plications as retrobulbar hemorrhage,endophthalmitis,cataract or retinal etachment occurred in all the affected eyes.Conclusions Retrobulbar injection of TA is of safety and effect in treating macular edema secondary to BRVO KEYacular edema therapy 1 对象与方法 1.1 对象 选择从2005年11月～2007年5月期间来我院就诊主诉视力下降、视物变形,检查眼底并经FFA、OCT确诊为视网膜分支静脉阻塞继发黄斑水肿,同时排除青光眼和高眼压、糖尿病的患者。所有患者及家属知情同意并签订球后注射TA治疗知情同意书，后进行球后注射TA 治疗。 本组选择符合纳入标准的患者共27例31只眼接受球后注射TA治疗。27例患者中有男性16例19只眼,女性11例12只眼,球后注射TA后随访观察6～8月。