【摘要】 目的观察玻璃体腔注射曲安奈德(TA)治疗视网膜静脉阻塞(RVO)继发黄斑水肿的疗效。方法对经间接检眼镜、荧光素眼底血管造影(FFA)以及光学相干断层扫描(OCT)检查确诊的RVO继发黄斑水肿患者39例39眼行TA玻璃体腔注射,治疗后随访1年,对比分析术前术后不同时期的视力、眼底、FFA表现,观察OCT显示黄斑水肿高度。结果中央视网膜静脉阻塞(CRVO)24眼(缺血型17眼,非缺血型7眼),分支视网膜静脉阻塞(BRVO)15眼(缺血型7眼,非缺血型8眼)。最终随访视力提高者28眼,比术前降低者5眼,不变者6眼。OCT形态恢复正常者15眼,改善者21眼,无改善者3眼。12眼术后出现一过性眼压升高。结论玻璃体腔注射TA是一种安全有效的治疗视网膜静脉阻塞继发黄斑水肿的方法。更多还原

【Abstract】 ObjectiveTriamcinolone acetonide(TA) is a long-lasting glucocorticoid.Intravitreal injection of TA can relieve macular edema caused by multiple fundus diseases.We worked to observe the therapeutic efficacy of intravitreal injection of triamcinolone acetonide(TA) for macular edema caused by retinal vein occlusion(RVO).MethodsTA was injected intravitreally in 39 eyes of 39 patients with macular edema secondary to RVO determined by indirect ophthalmoscope,fundus fluorescein angiography (FFA) and optic coherence tomography (OCT).The visual acuity,fundus findings,FFA and the macular thickness under the OCT were recorded and analyzed prior to operation and the different time points after operation.Follow-up time was 1 year.ResultsSeventeen eyes showed ischemic type of RVO,and 7 eyes were non-ischemic type of RVO among the central RVO patients,and those of branch RVO patients were in 7 eyes and 8 eyes,respectively.Visual acuity was improved at the end of follow-up in 28 eyes and decreased or unchanged in 5 eyes and 6 eyes,respectively.Fifteen eyes showed normal macular thickness after injection of TA with the mean edema height 574.9μm±174μm in postoperation.Improved fundus appearance was seen in 21 eyes with the mean edema height 813.7μm±215μm in preoperation and 497.6μm±144μm in postoperation.The fundus was unchanged or even worse in 3 eyes on OCT(preoperatively 645.0μm±70.4μm vs postoperatively 804.3μm±49.7μm) at the last visit.Intraocular pressure was elevated in 12 eyes.ConclusionIntravitreal injection of TA is a safe and effective method to the treatment of macular edema secondary to RVO.Further study should be performed to clarify its complications,prospective efficacy and its influence factors.更多还原