曲安奈德玻璃体腔注射治疗糖尿病性黄斑水肿34例

目的:评估玻璃体腔注射曲安奈德(intravitreal triamcinolone acetonide,IVTA)治疗糖尿病性黄斑水肿(diabetic macular edema,DME)的疗效。方法:DME患者34例39眼,采用40g/LIVTA0.1mL,治疗后1,3,6mo对比观察最佳矫正视力(best corrected visual acuity,BCVA),眼压、裂隙灯、光相干断层扫描(optical coherence tomography,OCT)、荧光素眼底血管造影(fundus fluorescein angiography,FFA)改变。结果:治疗前平均视力0.11±0.18,治疗后1,3,6mo平均视力分别提高至0.33±0.23,0.36±0.24,0.30±0.22,与治疗前比较差异均有统计意义(P<0.01)。OCT检查黄斑中心凹视网膜厚度(central macular thickness,CMT)治疗前603±150μm,治疗后1,3,6mo明显降低(P<0.01)分别是295±90μm,261±84μm,282±92μm。治疗后FFA检查荧光渗漏消失或明显减轻。8眼(21%)接受2次IVTA,眼压升高>22mmHg7眼。1眼发生后囊混浊性白内障。结论:IVTA治疗DME,能有效提高视力,降低黄斑视网膜厚度。

Intravitreal triamcinolone for the treatment of diabetic macular edema

AIM:To investigate the use of intravitreal triamcinolone acetonide(IVTA) for the treatment of diabetic macular edema(DME) .·METHODS:Thirty-four eyes of 39 patients with DME were included in this study. Intravitreal injection of triamcinolone acetonide at the dose of 40mg/mL in 0.1mL was admin-istered. The best corrected visual acuity(BCVA) ,intraocular pressure(IOP) ,slitlamp examination,optical coherence tomography(OCT) and fundus fluorescein angiography(FFA) were performed on the patients,and the results 1,3,6 months after injection were compared with those of the preoperative. ·RESULTS:Average visual acuity of 39 eyes was 0.11±0.18 before the treatment,while 1,3,and 6 months after the injection,mean visual acuity was improved to 0.33±0.23,0.36±0.24,0.30±0.22 which had statistical significance compared with that before the treatment(P<0.01) ;The average retinal thicknesses of central fovea of macula were 603±150μm,295±90μm,261±84μm and 282±92μm prior treatment,1,3,6 months after treatment respectively.There was statistically significant difference before and after the treatment(P<0.01) . FFA showed disappearance or alleviation of fluorescence leakage after treatment. 8 eyes(21%) received IVTA injections twice. IOP was raised above 22mmHg in 7 of 39 eyes. 1 eye developed posterior subcapsular cataract.·CONCLUSION:IVTA seems to be effective in improving vision and reducing macular thickness for the treatment of DME.