【摘要】 目的：评价乙酰唑胺治疗黄斑囊样水肿（ｃｙｓｔｏｉｄｍａｃｕｌａｒｅｄｅｍａ，ＣＭＥ）的疗效并探讨其药理机制。方法：经眼底荧光血管造影（ｆｕｎｄｕｓｆｌｕｏｒｅｓｃｅｉｎａｎｇｉｏｇｒａｐｈｙ，ＦＦＡ）检查证实的ＣＭＥ患者３７例４０只眼，随机分为两组，分别给予乙胺唑胺和安慰剂４周，４周后两组交叉给药继续观察４周。在不同阶段进行视力、ＦＦＡ、阈值化视野和视网膜电图（ｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ，ＥＲＧ）检测；对其中１２只眼进行了口服乙酰唑胺前后视网膜中央动脉血流的多普勒超声检测和视网膜血管计算机图像分析。结果：乙酰唑胺治疗组５２．５％的患眼黄斑水肿缓解或消退，７５．０％表现为视力提高，总体１０°阈值视野视敏度显著提高和ＥＲＧｂ波振幅明显增高，安慰剂组各项指标无明显改善，两组疗效有显著差别（Ｐ＜０．０５）。超声波检测显示ＣＭＥ眼血流缓慢。结论：乙酰唑胺具有明显提高患者视力、改善或缓解黄斑水肿的确切疗效，其机制可能与改善视网膜血流有关。更多还原

【Abstract】 OBJECTIVE:To evaluate the therapeutic effect of acetazolamide treatment on chronic cystoid macular edema(CME).METHODS:Thirty seven patients (40 eyes)with documented chronic CME of various causes were prospectively treated for 4-week periods with acetazolamide or a placebo in a randomised,crossover study that compared their effects on the reduction of macular edema and improvement of visual functions.Central retinal artery(CRA) blood flow was determined using Doppler velocimetry and vessel diameter measurement using computerised digital image analysis of monochromatic fundus photographs on 10 patients(12 eyes )with CME pre and post administration of acetazolamide.RESULTS:More than half the patients showed a response to acetazolamide with partial or complete resolution of edema.Thirty eyes had improved in visual acuity in the treated patients.Statistically significant improvement were seen in 10° thresholds of visual field and ERG b wave amplitude.No improvement was seen when the patients received placebo.There were significant increase of blood flow velocity in CRA and retinal vessels diameter after acetazolamide were administered 3 hours later in CME patients (P< 0.05). CONCLUSION:Acetazolamide could be of value in reducing the degree of edema and improving visual function to chronic CME.The improvement on retinal circulation might be a major cause to limit the CME.更多还原