视网膜静脉阻塞的临床治疗及疗效分析

目的 应用光学相干断层扫描长期随访视网膜静脉阻塞患者,观察视网膜黄斑水肿的变化情况,确定最佳的治疗方法和治疗时机.方法 将视网膜静脉阻塞患者75例,分成光凝治疗组,曲安奈德治疗组,联合治疗组.对比分析治疗前与治疗后1、3、6、12个月、2年视网膜神经上皮层厚度及视力的变化.将联合治疗组分成光凝术后1个月内和1个月后玻璃体腔内注射曲安奈德两小组.结果 (1)三组患者治疗后黄斑水肿明显减轻,治疗前与治疗后不同时期黄斑水肿高度比较差异有统计学意义(P<0.05).三组患者治疗后与治疗前相比,随访末次视力提高者分别为14、14和16例.将联合治疗组的两小组黄斑水肿高度进行比较,差异有统计学意义(P<0.05).光凝术后1个月内球内注射曲安奈德的患者长期疗效较好.(2)将三组患者随访末次黄斑水肿高度进行比较,差异有统计学意义(P<0.05).结论 长期疗效,联合治疗的疗效及视力的提高比较显著,且激光光凝治疗后1个月内球内注射曲安奈德对黄斑水肿的长期疗效更加显著.

Analysis of therapeutic effects of different clinical approaches for retinal vein occlusion

Objective The aim of the study was to compare the therapeutic effects of three clinical ap-proaches for the patients suffering from retinal vein occlusion by observing the changes in the macular edema using OCT.Methods Seventy-five patients suffering from retinal vein occlusion were divided into three groups: laser coagulation, intravitreai triamcinilone acetonide or the combination of the two methods.The exam-inations of OCT and visual acuity were carried out before the treatment and 1,3,6,12 and 24 months after the treatment.The group of patients treated with the combination of the methods was further divided in to two sub-groups according to the time of the intervals between the treatmentsece.Resuits We compared the reti-nal thickness of the three groups at last time follow-up periods.The difference was statistically significance(P <0.05).The visual acuity were improved.Conclusion The three methods were effective for the patients suffer-ing from retinal vein occlusion.The combination of the two methods compared with two other methods was more effective.The combination of the two methods,i.e.,intravitreal injection with triamcinolone acetonide within 1 month after the treatment of laser coagulation,were obviously effective.