[1]路迎龙,杜倩,李筱荣,等.葡萄膜炎继发黄斑囊样水肿的临床研究[J].眼科新进展,2017,37(2):147-150.[doi:10.13389/j.cnki.rao.2017.0039]
　LU Ying-Long,DU Qian,LI Xiao-Rong,et al.Efficacy of uveitis secondary to cystoid macular edema[J].Recent Advances in Ophthalmology,2017,37(2):147-150.[doi:10.13389/j.cnki.rao.2017.0039]
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葡萄膜炎继发黄斑囊样水肿的临床研究/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年2期
页码:
147-150
栏目:
应用研究
出版日期:
2017-02-05

文章信息/Info

Title:
Efficacy of uveitis secondary to cystoid macular edema
作者:
路迎龙; 杜倩; 李筱荣; 张晓敏
300384　天津市，天津医科大学眼科医院
Author(s):
LU Ying-Long; DU Qian; LI Xiao-Rong; ZHANG Xiao-Min
Tianjin Medical University Eye Hospital，Tianjin 300384，ChinaResponsible author:ZHANG Xiao-min,E-mail:xiaomzh@126.com;ORCID：0000-0003-4898-4152
关键词:
葡萄膜炎; 黄斑囊样水肿; 糖皮质激素; 黄斑前膜
Keywords:
uveitis; cystoid macular edema; corticosteroids; macular epiretinal membrane
分类号:
R774.1
DOI:
10.13389/j.cnki.rao.2017.0039
文献标志码:
A
摘要:
目的　观察葡萄膜炎继发黄斑囊样水肿（cystoid macular edema,CME）的预后及其影响因素。方法　回顾性分析2011 年8 月至2015 年 12月于天津医科大学眼科医院确诊为葡萄膜炎继发CME的31例(41眼)患者临床资料。观察治疗前后最佳矫正视力（best corrected visual acuity,BCVA）、黄斑中心凹视网膜厚度（central macular thickness,CMT）、黄斑其他并发症以及眼压变化。结果　27例（36眼）纳入数据分析。治疗后1个月，14眼（38.9%）CME完全缓解，BCVA（0.40±0.31） LogMAR较治疗前（0.66±0.36）LogMAR显著提高（P＜0.001），CMT(368.7±85.9) μm较治疗前 (469.0±99.1)μm显著降低（P＜0.001）。治疗后3个月，19眼（52.8%）CME完全缓解，BCVA（0.37±0.32）LogMAR及CMT(323.9±60.0)μm与治疗后1个月差异均无统计学意义（均为P＞0.05），与治疗前差异均有统计学意义（均为P＜0.001）。治疗后6个月，25眼（69.4%）CME完全缓解，BCVA（0.32±0.28）LogMAR与治疗前、治疗后1个月及3个月差异均有统计学意义（均为P＜0.05）。CMT（294.2±81.2）μm与治疗前及治疗后1个月差异均有统计学意义（均为P＜0.001），与治疗后3个月差异无统计学意义（P＞0.05）。治疗后6个月，11眼（30.6%）仍然存在CME，均伴发黄斑前膜。CMT的降低幅度（185.0±114.2）μm与BCVA的提高幅度（0.29±0.21）LogMAR之间无明显相关性（r=0.322,P=0.052），BCVA的提高幅度（0.29±0.21）LogMAR与CME病程（8.4±9.8）个月之间呈负相关（r=-0.395,P=0.015）。结论　目前现有全身和局部治疗可以有效治疗多数葡萄膜炎继发的CME，同时改善视力。视力改善程度与CME病程相关，黄斑前膜是影响黄斑水肿消退的重要因素。
Abstract:
Objective　To observe the prognosis and correlated factors of cystoid macular edema (CME) secondary to uveitis.Methods　A retrospective,noncomparative case series study.The clinical data of 31 uveitis patients with CME were collected from Uveitis & Ocular Immunology Service of Tianjin Medical University Eye Hospital from August 2011 to December 2015.Pre-treatment and post-treatment data were collected,including details of best-corrected visual acuity (BCVA),central macular thickness(CMT),other macular complications,and intraocular pressure(IOP).Results　Twenty-seven patients (36 eyes) were analyzed.At the 1st month after treatment,complete resolution of CME was achieved in 14 eyes (38.9%),BCVA increased from (0.66±0.36)LogMAR at baseline to (0.40±0.31) LogMAR (P＜0.001),and CMT decreased from (469.0±99.1)μm at baseline to (368.7±85.9)μm (P＜0.001).At the 3rd month after treatment,complete resolution of CME was found in 19 eyes (52.8%),no significant difference was found in CMT(323.9±60.0)μm or BCVA（0.37±0.32）LogMAR compared with the 1st month after treatment（P＞0.05）,significant difference was found in CMT（P＜0.001) or BCVA（P＜0.001) before the start of treatment.At the 6th month or more after treatment,complete resolution of CME occurred in 25 eyes (69.4%),BCVA（0.32±0.28）LogMAR was significant difference compared with that before the start of treatment（P＜0.05),at the 1st month（P＜0.05),at the 3rd month（P＜0.05).CMT（294.2±81.2）μm was significant difference compared with that before the start of treatment（P＜0.001),at the 1st month（P＜0.001),however,no significant difference was compared with that at the 3rd month（P＞0.05）.At the 6th month or more after treatment,11 eyes (30.6%) had a persistent macular edema,complicated with macular epiretinal membrane,no significant correlation between the reduction of CMT（185.0±114.2） μm and the improvement of BCVA（0.29±0.21）LogMAR was found (r=0.322,P=0.052),while the improvement of BCVA（0.29±0.21）LogMAR was negatively associated with the duration of CME（8.4±9.8）months（r=-0.395,P=0.015）.Conclusion　Current therapies are effective in curing most of the CME secondary to uveitis.The duration of CME is correlated with poor final visual acuity,the presence of ERM is an important factor associated with regression of CME.

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更新日期/Last Update: 2017-03-01