不同剂量IVTA治疗葡萄膜炎黄斑囊样水肿的疗效观察

目的:观察两种不同剂量曲安奈德玻璃体腔注射(intravitreal triamcinolone acetonide,IVTA)治疗葡萄膜炎黄斑囊样水肿的效果,并对其治疗结果和并发症情况进行比较。方法:分析研究2010-01/2012-01在我院确诊为双眼葡萄膜炎黄斑囊样水肿的患者6例12眼,每例患者双眼随机分为A,B两组进行曲安奈德玻璃体腔注射治疗,A组玻璃体腔注射4mg曲安奈德,B组玻璃体腔注射2mg曲安奈德。术后观察两组视力、眼压、黄斑中心凹厚度、晶状体透明度以及葡萄膜炎复发等。数据比较采用配对t检验。结果:术后视力均有大幅提高,术后OCT显示12眼(100%)黄斑囊样水肿均消失,黄斑中心凹厚度减低,与术前相比差异有统计学意义(P<0.01)。术前与术后两组间视力、黄斑区厚度相比差异无统计学意义(P>0.05)。两组术后各出现眼压升高3例3眼(50%),A组药物控制后眼压平均为44.33±7.51mmHg,B组为23.33±2.52mmHg,术后两组间眼压差异有统计学意义(P=0.01)。2例患者双眼随访期间发生并发性白内障,2例患者双眼葡萄膜炎黄斑囊样水肿复发。结论:IVTA是治疗葡萄膜炎黄斑囊样水肿的有效方法。并发症有眼压升高和并发性白内障。玻璃体腔注射4mg和2mg曲安奈德治疗葡萄膜炎黄斑囊样水肿的疗效相同,后者眼压升高的并发症易于应用药物控制。

Therapeutic efficiency of intravitreal triamcinolone acetonide in two different dosages in treating uveitis with cystoid macular edema

AIM: To observe the effects and complications of treatment foruveitis with cystoid macular edema with two different dosages of intravitreal triamcinolone acetonide(IVTA).

METHODS: Totally 6 cases(12 eyes)suffering from bilateraluveitis with cystoid macular edema were selected for the study from January 2010 to January 2012 treated in our hospital. Two eyes of each patient was divided into two groups randomly. Group A was treated with IVTA 4mg, group B was treated with IVTA 2mg. The visual acuity, intraocular pressure, foveal thickness, transparency of lens and recurrence of uveitis etc were examined postoperatively. The data were analyzed by t test.

RESULTS: The visual acuity of all patients was improved obviously after operations. A relief ofcystoid macular edema was observed in 12 eyes(100%)after operations, which was a significant difference contrast with preoperation(P<0.01). Preoperative and postoperative mean thickness of foveal in group A and group B had no difference(P>0.05). Three cases(3 eyes)in each group(50%)occurred high intraocular pressure. The mean intraocular pressure controlled with drugs of group A was 44.33±7.51mmHg, and group B was 23.33±2.52mmHg, which was significantly different(P=0.01)between two groups. Four eyes of 2 patients manifested cataract in each group. Four eyes of 2 patients underwent recurrent uveitis with cystoid macular edema after the treatment.

CONCLUSION: IVTA is an effective treatment foruveitis with cystoid macular edema. Complications include high intraocular pressure and progression of cataract. Therapeutic efficiency was the same of IVTA in two different dosages in treating uveitis with cystoid macular edema, but complication of high intraocular pressure was lower in IVTA 2mg than that of IVTA 4mg.