玻璃体腔注射曲安奈德治疗糖尿病性视网膜病变引起弥漫性黄斑水.docVIP

玻璃体腔注射曲安奈德治疗糖尿病性视网膜病变引起弥漫性黄斑水 　 作者：林艳辉　郭小健　朱小华　高建萍 【摘要】 　　目的：通过对糖尿病性视网膜病变引起的弥漫性黄斑水肿患者玻璃体腔注射曲安奈德，以减轻黄斑部水肿，增进视力。方法：选择视网膜静脉阻塞患者13例17眼，向玻璃体腔注射曲安奈德4mg/0.1mL，术前、术后及术后,1，2，3，6mo分别进行最佳矫正视力、OCT、HRT-II检查。结果：术后6mo各随访时间点平均视力均较术前显著提高（P lt;0.001）,术后6mo与术后3mo比较，视力显著回退(P =0.033)；术后6mo内黄斑中心凹1mm范围内神经感觉层平均厚度与术前比较，显著降低（P lt;0.001），术后6mo较术后3mo有显著增厚（P ＝0.001）；术后3mo各随访时间点e值较术前显著降低（P ＝0.000）。结论：玻璃体腔注射曲安奈德在短期内能够有效减轻由糖尿病性视网膜病变引起的弥漫性黄斑水肿，恢复视力，但随后疗效会逐渐减退。 【关键词】 曲安奈德　黄斑水肿　糖尿病性视网膜病变 　　Intravitreous injection with triamcinolone acetonide for diffused diabetic macular edema Abstract AIM: To observe the therapeutic effect of intravitreous injection with triamcinolone acetonide(TA) on diffused diabetic macular edema. METHODS: This prospective study involved 13 patients (17 cases) who received one injection of 4mg/0.1mL TA into the vitreous. The main outcome measures included best-corrected visual acuity, macular oedema map values of Heidelberg Retinal Tomograph II (HRT II), and optical coherence tomography (OCT) before and after intravitreal triamcinolone injection. RESULTS: Mean best-corrected visual acuity (BCVA) in 6 months after injection was improved which was significantly better than at baseline (P﹤0.001) . BCVA at the 6th months was significantly worse compared to that at the 3rd months follow-up(P =0.033);The thickness of the retinal neurosensory in DME patients at 6.00 mm from the macular fovea in 6 months after injection had a significantly descend compared to baseline (P﹤0.001). While at the 6th month after injection it was significantly deeper compared to that at the 3rd month follow-up (P =0.001), Macular edema index in 3 months after injection descended which was significantly lower than at baseline (P =0.000). CONCLUSION: Intravitreous injection with TA is effective for diffused diabetic macular edema in a short time. · KEYWORDS: triamcinolone acetonide; macular edema 　　0引言 黄斑水肿是许多眼底病的并发症，是引起视力减退的重要原因之一，糖尿病性视网膜病变和视网膜静脉阻塞是最常见的原因[1]。传统的黄斑部格栅样光凝和药物治疗如皮质类固醇等并不能满足要求。曲安奈德是人工合成的一种非水溶性的