[1]翁宏武,王柯鳗,马海智,等.玻璃体内注射曲安奈德联合黄斑部格栅样光凝治疗弥漫性糖尿病性黄斑水肿[J].眼科新进展,2016,36(11):1050-1053.[doi:10.13389/j.cnki.rao.2016.0280]
　WENG Hong-Wu,WANG Ke-Man,MA Hai-Zhi,et al.Intravitreal triamcinolone acetonide and macular grid photocoagulation for diffuse diabetic macular edema[J].Recent Advances in Ophthalmology,2016,36(11):1050-1053.[doi:10.13389/j.cnki.rao.2016.0280]
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玻璃体内注射曲安奈德联合黄斑部格栅样光凝治疗弥漫性糖尿病性黄斑水肿
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
36卷
期数:
2016年11期
页码:
1050-1053
栏目:
应用研究
出版日期:
2016-11-05

文章信息/Info

Title:
Intravitreal triamcinolone acetonide and macular grid photocoagulation for diffuse diabetic macular edema
作者:
翁宏武; 王柯鳗; 马海智; 赵聪梅; 叶国; 晏世刚
524000　广东省湛江市，广东医科大学第一临床医学院
Author(s):
WENG Hong-Wu;  WANG Ke-Man;  MA Hai-Zhi;  ZHAO Cong-Mei;  YE Guo; YAN Shi-Gang
First Clinical College, Guangdong Medical University, Zhanjiang 524000 , Guangdong Province , China
关键词:
弥漫性糖尿病性黄斑水肿; 曲安奈德; 玻璃体内注射; 黄斑部格栅样光凝
Keywords:
diffuse diabetic macular edema;  triamcinolone acetonide ;  vitreous injection ;  macular grid photocoagulation
分类号:
Ｒ７７４.５
DOI:
10.13389/j.cnki.rao.2016.0280
文献标志码:
A
摘要:
目的　评价玻璃体内注射曲安奈德（ｔｒｉａｍｃｉｎｏｌｏｎｅａｃｅｔｏｎｉｄｅ，ＴＡ）联合黄斑部格栅样光凝治疗弥漫性糖尿病性黄斑水肿（ｄｉａｂｅｔｉｃｍａｃｕｌａｒｅｄｅｍａ，ＤＭＥ）短期的临床疗效和安全性。方法　将３５例（３９眼）弥漫性ＤＭＥ患者根据治疗方法不同分为２组，分别为单纯ＴＡ治疗组（２４眼）和联合治疗组（ＴＡ注射联合黄斑部格栅样光凝术，１５眼）。其中联合治疗组在ＴＡ注射１个月后行黄斑部格栅样光凝术，距ＴＡ注射术后３个月、６个月分别观察２组患者最佳矫正视力、眼压、裂隙灯显微镜、彩色眼底照相、ＯＣＴ及并发症情况。结果　治疗后３个月，单纯ＴＡ治疗组和联合治疗组最佳矫正视力分别为０．１６±０．０８、０．１６±０．１７，黄斑中心凹视网膜厚度分别为（２７２．２±５９．４）μｍ、（２７９．０±９８．９）μｍ，眼压分别为（１５．４±４．３）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ）、（１４．９±３．２）ｍｍＨｇ，２组间最佳矫正视力、黄斑中心凹视网膜厚度和眼压比较差异均无统计学意义（均为Ｐ＞０．０５）；治疗后６个月，单纯ＴＡ治疗组和联合治疗组最佳矫正视力分别为０．２７±０．０３、０．２８±０．１５，黄斑中心凹视网膜厚度分别为（２８９．２±３３．９）μｍ、（２４８．０±１０２．７）μｍ，眼压分别为（１５．５±２．３）ｍｍＨｇ、（１５．１±３．５）ｍｍＨｇ，２组间最佳矫正视力、黄斑中心凹视网膜厚度和眼压比较差异亦均无统计学意义（均为Ｐ＞０．０５）。与治疗前视力相比，两组在治疗后３个月、６个月均有所提高，与治疗前黄斑中心凹视网膜厚度相比，两组均有所下降，与治疗前眼压相比，两组无明显变化。结论　与单纯ＴＡ注射相比，玻璃体内注射ＴＡ联合黄斑部格栅样光凝治疗弥漫性ＤＭＥ短期内疗效和安全性并不占据明显优势。鉴于本次病例观察时间较短，尤其再次治疗的患者例数较少，故其远期疗效、安全性仍有待大样本的长期观察。
Abstract:
Objective To evaluate the efficacy and safety of intravitreal triamcinolone acetonide ( TA) injection combined with macular grid photocoagulation for diffuse diabetic macular edema ( DME) . Methods Thirty-five cases ( 39 eyes) with diffuse DME were randomly divided into TA injection group ( 24 eyes) and combined treatment group ( intravitreal injection of TA combined with macular grid photocoagulation, 15 eyes) . The combined treatment group underwent macular grid section photocoagulation surgery after I month of TA injection, the best corrected visual acuity , intraocular pressure ( IOP) . slit lamp , color fundus photography , FFA and OCT and complications were observed at 3 months and 6 months after TA injection. Results The best corrected visual acuity at 3 months in TA injection group and combined treatment group were 0. 16 +0. 08 and 0. 16 + 0. 17 , respectively; The foveal retinal thickness were ( 272. 2 + 59. 4) ym and ( 279. 0 + 98. 9) Vm , respectively ; The intraocular pressure were ( 15. 4 + 4. 3) mmHg ( I kPa = 7. 5 mmHg ) and ( 14. 9 + 3. 2) mmHg , respectively ; The differences in best corrected visual acuity , foveal retinal thickness and intraocular pressure was not statistically significant ( all P > 0. 05 ) . The best corrected visual acuity at 6 months in TA injection group and combined treatment group were 0. 27 + 0. 03 and 0. 28 + 0. 15 , respectively;The foveal retinal thickness were ( 289. 2 + 33. 9) ym and ( 248. 0 + 102. 7 ) ym , respectively ; The intraocular pressure were ( 15. 5 + 2. 3 ) mmHg ( 15. I + 3. 5 ) mm-Hg , respectively ; The differences in best corrected visual acuity , foveal retinal thickness and intraocular pressure was not statistically significant ( all P > 0. 05 ) . Compared with pre-operation.the visual acuity at 3 months .6 months after treatment in the two groups improved;the foveal retinal thickness were decreased; the intraocular pressure had no obvious change. Conclusion Compared with the simple TA injection, the efficacy and safety of TA combined with macular laser photocoagulation for diffuse DME is not dominant in the short term. In view of this case observation time is shorter,in particular , the number of patients treated with less , so its exact effect, safety of the treatment are still need a large sample for further long-term observation.

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备注/Memo

备注/Memo:
佛山市医学重点专科培育项目（编号：Ｆｓｐｙ１-２０１５００５）
更新日期/Last Update: 2016-11-29