两种剂量曲安奈德玻璃体腔注射治疗糖尿病性黄斑水肿的疗效及安全性对比

目的观察2 mg和4 mg曲安奈德（ TA）玻璃体腔内注射治疗糖尿病性黄斑水肿的疗效及并发症的差异性。方法54例（58只眼）糖尿病性弥漫性黄斑水肿病例随机分成2组，A组29例（31只眼）玻璃体腔注射2 mg TA，B组25例（27只眼）玻璃体腔内注射4 mg TA，术后随访6个月，观察术后视力、眼压、晶状体、视网膜厚度改变及眼内炎发生情况。结果术后3个月，A组视力0．12±0．21，B组视力0．16±0．25，两组比较差异无统计学意义。术后6个月，A组视力0．14±0．16，B组视力0．15±0．23，两组比较差异无统计学意义。术后3个月视网膜厚度A组（241．32＋50．13）μm，B组（238．62±56．75）μm，两组比较差异无统计学意义。术后6个月A组（286．17＋51．31）μm，B组（245．56±61．75）μm，两组比较差异无统计学意义。 A组术后3个月6只眼眼压大于21 mmHg， B组8只眼眼压大于21 mmHg，差异无统计学意义。术后6个月A组2只眼眼压超过21 mmHg，B组5只眼眼压超过21 mmHg，两组比较差异无统计学意义。术后3个月A组晶状体混浊加重2只眼，B组8只眼，差异有统计学意义。术后6个月A组晶状体混浊加重4只眼。 B组11只眼，差异有统计学意义。两组患者术后均未见眼内炎发生。结论2 mg及4 mg曲安奈德玻璃体腔内注射治疗糖尿病性黄斑水肿，两者在提高患者视力、减轻视网膜水肿疗效无差异性，但4 mg较2 mg的剂量更容易引起白内障加重。

Comparison of the efficacy and safety of intravitreal injection with two different doses of triamcinolone ace-tonide in the treatment of diabetic macular edema

Objective To observe the differences in efficacy and safety between 2mg and 4mg triamcinolone ace-tonide intravitreal injection in the treatment of diabetic macular edema .Methods Diabetic diffuse macular edema patients (54 patients, 58 eyes) were randomly divided into two groups .Group A (29 patients, 31 eyes) received 2mg triamcinolo-ne acetonide intravitreal injection while Group B (25 patients, 27 eyes) received 4mg triamcinolone acetonide .The follow-up last for 6 months.Visual acuity, intraocular pressure, lens, retina thickness and occurrence of endophthalmitis were re-corded and compared.Results Three months after the injection, visual acuity was 0.12 ±0.21 in group A (low dose) and 0.16 ±0.25 in group B (high dose), but this difference was not statistically significant .At 6 months the visual acuity was also not significantly different between the two groups of patients .At 3 months, retinal thickness was 241.32 ±50.13μm in group A and 238.62 ±56.75μm in group B.No significant difference was found .IOP elevated (>21 mmHg) in 6 eyes in group A and in 8 eyes in group B at 3 months.At 6 months, elevated IOP was found in 2 eyes in group A and 5 eyes in group B.Development of cataract was found in 2 eyes in group A and 8 eyes in group B at 3 months and 4 eyes ver-sus 8 eyes at 6 months.There was no endophthalmitis reported .There was no difference in occurrence rate of either elevat-ed IOP or cataract between the two groups .Conclusions Both 2mg and 4mg triamcinolone acetonide intravitreal injection improve visual acuity and reduce retinal edema in diabetic macular edema patients .It appeared that 4mg dosage will more likely to aggravate cataract .