| 视网膜分支静脉阻塞合并黄斑水肿不同治疗方法的疗效观察 |
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| 引用本文： | 曹婷婷,陈桂芬,范玉香,王志学,李朝霞. 视网膜分支静脉阻塞合并黄斑水肿不同治疗方法的疗效观察[J]. 眼科新进展, 2014, 0(8): 772-775. DOI: 10.13389/j.cnki.rao.2014.0213 |
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| 作者姓名： | 曹婷婷 陈桂芬 范玉香 王志学 李朝霞 |
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| 作者单位： | 河北省沧州市，沧州市中心医院眼一科 |
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| 摘 要： | 目的 通过对视网膜分支静脉阻塞（ｂｒａｎｃｈｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＢＲＶＯ）在不同时期进行光凝及光凝联合玻璃体内注射曲安奈德治疗进行比较，探索治疗ＢＲＶＯ合并黄斑水肿更为有效的方法。方法 ７５例ＢＲＶＯ患者纳入研究，均为单眼。将所有患者分为５组，Ａ组１４例、病程为３～６个月，Ｂ组１６例、病程＜３个月，以上两组入选后即行黄斑区局部格栅样光凝及颞上象限局部光凝治疗，Ｃ、Ｄ、Ｅ组均为入选后即行玻璃体内注射曲安奈德４ｍｇ，注射后光凝时间分别为２周、４周、６周，每组１５例。对比观察５组治疗前后最佳矫正视力（ｂｅｓｔｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ，ＢＣＶＡ）、光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ， ＯＣＴ）、多焦视网膜电图（ｍｕｌｔｉｆｏｃａｌｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ，ｍｆＥＲＧ）结果。结果 ＢＣＶＡ:５组中以Ｃ组ＢＣＶＡ改善最为显著，优于Ａ、Ｂ、Ｄ、Ｅ组（均为Ｐ＜０．０５）。ＯＣＴ结果:Ｃ组最终黄斑中心凹厚度与Ａ、Ｂ、Ｄ、Ｅ组相比，差异均有统计学意义（均为Ｐ＜０．０５），Ｄ、Ｅ组均明显低于Ａ、Ｂ组（均为Ｐ＜０．０５）。ｍｆＥＲＧ结果:Ｃ、Ｄ、Ｅ各组黄斑区（即１、２环）Ｐ１、Ｎ１波振幅密度分别与Ａ、Ｂ组比较明显增加，差异均有统计学意义（均为Ｐ＜０．０５）。结论 玻璃体内注射曲安奈德联合光凝治疗ＢＲＶＯ效果优于单纯激光治疗，玻璃体内注射曲安奈德２周后行激光光凝治疗效果最佳。
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| 关 键 词： | 视网膜分支静脉阻塞 黄斑水肿 曲安奈德 光凝时机 |
Clinical observation in different treatment methods of branch retinal vein occlusion |
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| CAO Ting-Ting,CHEN Gui-Fen,FAN Yu-Xiang,WANG Zhi-Xue,Li Zhao-Xia. Clinical observation in different treatment methods of branch retinal vein occlusion[J]. Recent Advances in Ophthalmology, 2014, 0(8): 772-775. DOI: 10.13389/j.cnki.rao.2014.0213 |
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| Authors: | CAO Ting-Ting CHEN Gui-Fen FAN Yu-Xiang WANG Zhi-Xue Li Zhao-Xia |
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| Abstract: | Objective To explore the more effective method for branch retinal vein occlusion ( BRVO)with macular edema by analyzing the laser coagulation and intravitreal injection of triamcinolone acetonide combined with laser coagulation in different periods. Methods Seven-five BRVO patients ( 75 eyes) included in this research. and divided into five groups , 14 cases in group A with duration of 3 - 6 months . 16 cases in group B with duration less than 3 months , group A and B were treated with macular and superior-temple local area laser at once. The patients in group C , D and E received the intravitreal injection of 4 mg triamcinolone acetorude at once, then performed the photocoagulation for 2 weeks ,4 weeks and 6 weeks . 15 cases rn each group. The preoperative and postoperative best correct visual acuity ( BCVA) , optical coherence tomography ( OCT) and multifocal electroretinogram ( mfERG) were compared among five groups. Results BCVA in group C improved the most sigruficant , better than group A, B , D and E ( all P < 0. 05 ) . There were statistical differences in macular foveal thickness between group C and group A,B.D and E ( all P <0. 05) , and group D and E were lower than group A and B ( all P < 0. 05 ) . The amplitude density of Pl ,NI wave at macular area ( ring I ,2)in group C,D,E were higher than those in group A and B.there were statistical differences ( all P < 0. 05 ) . Conclusion The intravitreal injection of triamcinolone acetonide combined with laser coagulation has better effects than single laser coagulation,and laser coagulation at 2 weeks after triamcinolone acetonide injection can achieve the best effects. |
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| Keywords: | branch retinal vein occlusion macular edema triamcinolone acetonide photocoagulation opportunity |
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