玻璃体腔内注射曲安奈德治疗弥漫性糖尿病黄斑水肿的临床疗效研究

目的:研究玻璃体腔内单次注射曲安奈德(TA)治疗非增殖性弥漫性糖尿病黄斑水肿(DME)的疗效及安全性.方法:玻璃体腔内单次注射TA4mg/0.1mL治疗非增殖性弥漫性DME25眼,观察治疗前后视力、黄斑区视网膜神经感觉层厚度、眼压的变化以及并发症的发生情况.结果:治疗后1mo与治疗前相比,视力提高显著(P=0.0004);治疗后3mo与治疗后1mo比较,视力显著提高(P=0.0006);治疗后6mo与治疗前相比,视力无显著性差异(P=0.0935).治疗后1mo黄斑区周围1.00mm范围内视网膜神经感觉层厚度与治疗前相比,显著降低(P=0.0000);治疗后3mo与治疗后1mo相比,显著降低(P=0.0303);治疗后6mo后与治疗后3mo相比,显著升高(P=0.0000),但与治疗后1mo相比,仍显著降低(P=0.0000).治疗后10.40min眼压与治疗前相比显著升高(P=0.0000);而治疗后1d与治疗前相比无显著性差异(P=0.1766).结论:玻璃体腔内单次注射TA 4mg/0.1mL治疗非增殖性弥漫性DME,短期疗效确实,可以明显减轻水肿、改善患者视功能,安伞性较高.

Clinical therapeutic effects of intracavity injection of triamcinolone acetonide for diffuse diabetic macular edema

AIM:To observe clinical therapeutic effects and safety of single intracavity injection of triamcinolone acetonide(TA) for nonproliferative diffuse diabetic macular edema(DME). METHODS:Twenty-five eyes with nonproliferative diffuse DME received single injection of 4mg/0.1mL TA into vitreous. Mean best-corrected visual acuity,thickness of the neurosensory retina,intraocular pressure (IOP) and adverse reaction were observed and analyzed. RESULTS:Mean best-corrected visual acuity (BCVA) at one month follow-up was significantly better than that at baseline (P =0.0004). After three months follow-up,BCVA improved significantly compared to that after one month follow-up (P=0.0006). The six months follow-up BCVA had no significantly difference with the baseline (P =0.0935). The thickness of neurosensory retina at 1.00mm from the macular fovea at one month after injection had an significantly decline compared to baseline (P =0.0000),and it at three months follow-up time points was significantly fewer compared to that at one month follow-up time points (P =0.303). However,at six months follow-up the thickness of neurosensory retina increased again,but it was still fewer than the baseline (P =0.0000). Mean IOP at ten minutes and forty minutes follow-up were significantly higher (P =0.0000) than the baseline,while it decreased to the normal level one day later. CONCLUSION:Single intracavity injection of 4mg/0.1mL TA for nonproliferative diffuse DME is an effective and safe method.