【摘要】 目的探讨重组人组织型纤溶酶原激活剂和惰性气体联合注射在年龄相关性黄斑变性(AMD)视网膜前出血治疗中的疗效。方法对连续就诊的AMD视网膜前出血的确诊病例24例实施低剂量重组人组织型纤溶酶原激活剂和惰性气体联合玻璃体腔注射,对比观察手术前后视力变化、眼压、光相干断层扫描(OCT)、眼底表现及术后并发症等。结果在所有接受治疗的24例患者中18例术后最佳矫正视力有不同程度提高(75%),与术前视力比较,有统计学显著性差异(P<0.05)。视网膜前出血发生重新分布,逐渐溶解并最终完全吸收。术后除5例出现一过性眼压升高,未发生视网膜脱离及眼内炎等严重并发症。结论低剂量重组人组织型纤溶酶原激活剂和惰性气体玻璃体腔联合注射这一微创治疗方法在AMD视网膜前出血治疗中起到积极的治疗作用。更多还原

【Abstract】 Objective To evaluate the therapeutical effect of the intravitreal application of the human recombinant tissue plasminogen tissue activator (rt-PA) and expansive gas in the treatment of preretinal hemorrhage caused by age-related macular degeneration (AMD). Methods 24cases diagnosed of preretinal hemorrhage associated with AMD received intravitreal injection (rt-PA) combined with expansive gas treatment. Main outcome measures included: preoperative/postoperative best-corrected visual acuity (VA),surgical complications,fundus image and foveal situation measured by third generation ocular coherence tomography (OCT). The average period of follow-up was 6 months. Results After treatment,the mean postoperative VA increased significantly in 18 cases of 24 eyes (75 %). The preretinal hemorrhage lysed and disappeared,and the choroidal neovascular membrane got atrophic. No severe complications such as secondary glaucoma or endophthalmitis were observed. Conclusion The intravitreal application of the tissue plasminogen activator and expansive gas plays an important role in the treatment of preretinal hemorrhage associated with AMD. This minimally invasive procedure gives the possibility to treat this prognostic unfavorable disease.更多还原