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目的研究玻璃体腔内注射曲安奈德(TA)治疗重度糖尿病黄斑水肿的有效性。方法对36例(42眼)重度糖尿病黄斑水肿的患者,行玻璃体腔内注射TA(进口)(4mg/0.1ml)的治疗方法。观察治疗前后的四个指标:最佳矫正视力、眼压、眼底荧光血管造影(FFA)、OCT检测黄斑中心凹厚度。随访时间6～12个月(平均9个月)。结果本组病例36例(42眼),年龄45～70岁(平均57岁),FFA检查治疗前黄斑荧光渗漏明显,治疗后渗漏明显减轻;OCT检测黄斑中心凹厚度,治疗前平均(579.5±65)μm,治疗随访6个月后平均(279±78)μm,差异有统计学意义(P<0.05);最佳矫正视力范围治疗前为0.01～0.2,平均0.1,治疗后为0.2～0.4,平均0.3,差异有统计学意义(P>0.05);所有患者眼压都有升高,升高值8.0～20.0mmHg(平均14.0mmHg),7例(7眼)超过正常眼压范围,经治疗,眼压控制,没有严重并发症发生。结论玻璃体腔注射TA是治疗重度糖尿病黄斑水肿的有效方法,患者的视力有轻度提高,治疗后患者FFA,黄斑区荧光素渗漏明显减轻,OCT检查,证实黄斑厚度明显减小。
Objective To study the efficacy of intravitreous injection of triamcinolone acetonide (TA) in the treatment of severe diabetic macular edema. Methods Thirty-six patients (42 eyes) with severe diabetic macular edema were treated with intravitreal injection of TA (4mg / 0.1ml). Four indicators before and after treatment were observed: best corrected visual acuity, intraocular pressure, fundus fluorescein angiography (FFA) and OCT for macular foveal thickness. Follow-up time of 6 to 12 months (mean 9 months). Results The group of 36 patients (42 eyes), aged 45 to 70 years (mean 57 years), FFA before treatment macular fluorescence leakage significantly reduced leakage after treatment; OCT detection foveal thickness, average ( 579.5 ± 65) μm, and the mean follow-up was (279 ± 78) μm after 6 months of follow-up. The difference was statistically significant (P0.05) .The best corrected visual acuity range was 0.01-0.2 before treatment, ~ 0.4, an average of 0.3, the difference was statistically significant (P> 0.05); all patients had elevated intraocular pressure, elevated 8.0 ~ 20.0mmHg (average 14.0mmHg), 7 cases , After treatment, intraocular pressure control, no serious complications. Conclusion Intravitreal injection of TA is an effective method for the treatment of severe diabetic macular edema. The visual acuity of patients with mild diabetic macular edema is slightly increased. Fluorescein leakage in FFA and macula is significantly reduced after treatment. The thickness of macula is significantly reduced by OCT.